Italian Multicenter Study on Low-Density Lipoprotein Apheresis Working Group 2009 Survey

Claudia Stefanutti, Claudia Morozzi, Serafina Di Giacomo, Luigi Dell'Orso, Giuseppe Migliori, Stefano Baravelli, Ghil Busnach, Patrizia Vatieri, Giustina De Silvestro, Piero Marson, Rosalia Agliastro, Patrizia Accorsi, Cecilia Passeri, Giovanna D'Alessandri, Adriana Tognaccini, Amato Marcello, Gianpaolo Russi, Maria Cossu, Pietro Giorgio Pala, Luciangela CalvisiLuigi Cattin, Maurizio Fonda, Lorella Poli, Maria Grazia Zenti, Giulia De Fusco, Maria Rita Guitarrini

Research output: Contribution to journalArticle

Abstract

We present results of the second survey of the Italian Multicenter Study on Low-Density Lipoprotein Apheresis (IMSLDLa-WG/2). The study involved 18 centers in 2009, treating 66 males and 35 females, mean age 47±18 years. Mean age for initiation of drug treatment before low-density lipoprotein apheresis (LDLa) was 31±18 years, mean age to the first LDLa was 37±20 years and average duration of treatment was 9±6 years. The techniques used included direct adsorption of lipids, dextran sulfate cellulose adsorption, heparin-mediated low-density lipoprotein (LDL) precipitation, cascade filtration, and plasma exchange. The mean treated plasma/blood volumes/session were 3127±518mL and 8666±1384mL, respectively. The average plasma volume substituted was 3500±300mL. Lipid therapy before LDLa included ezetimibe, statins, ω-3 fatty acids and fenofibrate. Baseline mean LDL cholesterol (LDLC) levels were 386±223mg/dL. The mean before/after apheresis LDLC level decreased by 67% from 250±108mg/dL (P=0.05 vs. baseline) to 83±37mg/dL (P=0.001 vs. before). Baseline mean Lipoprotein(a) [Lp(a)] level was 179±136mg/dL. Mean before/after apheresis Lp(a) level decreased by 71% from 133±120mg/dL (P=0.05 vs. baseline) to 39±44mg/dL (P=0.001 vs. before). Major and minor side effects occurred in 27 and 62 patients, respectively. Among patients with coronary artery disease (CAD), 62.3% had coronary angiography and 50.4% coronary revascularization before LDLa. Single vessel, double vessel and triple vessel CAD occurred in 19 (30.1%), 15 (23.8%) and 29 (46%) patients, respectively. Both CAD and extra-CAD occurred in 41.5%, 39% had hypertension, 9.9% were smokers, 9.9% consumed alcohol and 42% were physically active. Ischemic cardiovascular events were not observed in any patient over 9±6 years of treatment. Two centers have also treated 34 patients (females: 17/males 17; no. sessions: 36; average plasma volume treated: 3000mL) for sudden hearing loss (SHL). Relief of symptoms was obtained, independently of the system used (HELP; cascade-filtration).

Original languageEnglish
Pages (from-to)169-178
Number of pages10
JournalTherapeutic Apheresis and Dialysis
Volume17
Issue number2
DOIs
Publication statusPublished - Apr 2013

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Keywords

  • Coronary artery disease
  • Genetic dyslipidemia
  • Low-density lipoprotein apheresis
  • Multicenter study
  • Therapeutic plasmapheresis

ASJC Scopus subject areas

  • Hematology
  • Nephrology

Cite this

Stefanutti, C., Morozzi, C., Di Giacomo, S., Dell'Orso, L., Migliori, G., Baravelli, S., Busnach, G., Vatieri, P., De Silvestro, G., Marson, P., Agliastro, R., Accorsi, P., Passeri, C., D'Alessandri, G., Tognaccini, A., Marcello, A., Russi, G., Cossu, M., Pala, P. G., ... Guitarrini, M. R. (2013). Italian Multicenter Study on Low-Density Lipoprotein Apheresis Working Group 2009 Survey. Therapeutic Apheresis and Dialysis, 17(2), 169-178. https://doi.org/10.1111/j.1744-9987.2012.01142.x