LDL apheresis in the treatment of familial hypercholesterolemia: experience of Hospital Santo António, Porto

Abstract

Introduction: High plasma levels of low-density lipoprotein (LDL) cholesterol are a risk factor for the development of premature atherosclerosis. Direct adsorption of lipoproteins (DALI) is an apheresis technique by which LDL cholesterol is selectively removed from whole blood.

Objective: The present study describes our experience with DALI LDL apheresis in severely hypercholesterolemic patients.

Methods: Three hypercholesterolemic patients suffering from atherosclerotic complications were treated fortnightly by DALI apheresis, in a total of 308 sessions between December 2008 and January 2013. All patients were on the highest tolerated dose of statins and other lipid-lowering drugs.

Results: The sessions were essentially uneventful, adverse events being recorded in only 3.6% of them. A mean 63.3% acute reduction in LDL cholesterol was obtained.

Conclusion: DALI apheresis proved to be a simple, safe and efficient method of lipid apheresis in hypercholesterolemic patients refractory to conservative lipid-lowering therapy.

Keywords: Adsorção direta de lipoproteínas‐aférese; Cardiovascular disease; Direct adsorption of lipoprotein apheresis; Doença cardiovascular; Familial hypercholesterolemia; Hipercolesterolemia familiar; Lipoproteína (a); Lipoproteínas de baixa densidade‐aférese; Low‐density lipoprotein apheresis; Serum lipoprotein(a).