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The Lipoprotein-apheresis (LA) devices used in North America for Familial Hypercholesterolemia (FH) reduce LDL-C (− 80%) by binding positive charged apolipoprotein B (apoB) to a negative charged environment. FH patients also have low HDL-C levels, and despite their negative charge, HDL-C is acutely reduced by LA (4-32%) but increased over long term therapy. Previous studies have demonstrated LA's selective removal of both inflammatory and apoE-bound HDL.
To determine the effects of different LA devices on the plasma concentration of HDL-C, apoA1, and HDL particles (HDL-P).
We examined 26 (F=18) FH patients receiving bi-weekly LA with either the HELP Futura (B. Braun), which filters 3000 mL of plasma per treatment, or the Liposorber, MA-03 (Kaneka), which filters, on average, 4500 mL of plasma. Labs were measured immediately before and after LA. The paired Student's t test for normally distributed variables and a sign rank test for non-parametric variables were used for statistical analysis.
(see table) HDL-C and apoA1 decreased by 24% and 11% (p=0.001) while HDL-P increased by 16% (p<0.001). HDL-P increase was greater with the Liposorber system (p=0.002).
LA appears to selectively reduce an HDL-C molecule with low apoA1 and HDL-P. The Liposorber system significantly increases HDL-P more, which may be attributed to the volume of treated plasma or through another mechanism. Further research is needed to evaluate the significance of these observations.
|Parameter||Preapheresis value||Postapheresis value||Average change (%)n=26||p Value||Average change (%) (Braun) n=14||Average change (%)(Kaneka) n=12||p Value|
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Prevention: LV, Vascular and Lipoprotein Function
Abstract Category: 24. Prevention: Clinical
Presentation Number: 1233-17
- 2013 American College of Cardiology Foundation