Universität zu Köln

Roeseler, Eberhard, Julius, Ulrich, Heigl, Franz, Spitthoever, Ralf, Heutling, Dennis, Breitenberger, Paul, Leebmann, Josef, Lehmacher, Walter, Kamstrup, Pia R., Nordestgaard, Borge G., Maerz, Winfried, Noureen, Asma, Schmidt, Konrad, Kronenberg, Florian ORCID: 0000-0003-2229-1120, Heibges, Andreas and Klingel, Reinhard (2016). Lipoprotein Apheresis for Lipoprotein(a)-Associated Cardiovascular Disease: Prospective 5 Years of Follow-Up and Apolipoprotein(a) Characterization. Arterioscler. Thromb. Vasc. Biol., 36 (9). S. 2019 - 2028. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1524-4636

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Abstract

Objective Lipoprotein(a)-hyperlipoproteinemia (Lp(a)-HLP) along with progressive cardiovascular disease has been approved as indication for regular lipoprotein apheresis (LA) in Germany since 2008. We aimed to study the long-term preventive effect of LA and to assess hypothetical clinical correlations of apolipoprotein(a) (apo(a)) by analyzing genotypes and phenotypes. Approach and Results This prospective observational multicenter study included 170 patients with Lp(a)-HLP and progressive cardiovascular disease (48.9 years median age at diagnosis) despite other cardiovascular risk factors, including low-density lipoprotein cholesterol had maximally been treated (mean baseline low-density lipoprotein cholesterol: measured, 2.56 mmol/L [98.9 mg/dL] and corrected, 1.72 mmol/L [66.3 mg/dL]). Patients were prospectively investigated during a 5-year period about annual incidence rates of cardiovascular events. In addition, apo(a) isoforms and polymorphisms at the apo(a) gene (LPA) were characterized. One hundred fifty-four patients (90.6%) completed 5 years of follow-up. Mean Lp(a) concentration before commencing regular LA was 108.1 mg/dL. This was reduced by a single LA treatment by 68.1% on average. Significant decline of the mean annual cardiovascular event rate was observed from 0.580.53 2 years before regular LA to 0.11 +/- 0.15 thereafter (P<0.0001); 95.3% of patients expressed at least 1 small apo(a) isoform. Small apo(a) isoform (35.2%) carrying phenotypes were not tagged by single-nucleotide polymorphisms rs10455872 or rs3798220. Conclusions Results of 5 years of prospective follow-up confirm that LA has a lasting effect on prevention of cardiovascular events in patients with Lp(a)-HLP. Patients clinically selected by progressive cardiovascular disease were characterized by a highly frequent expression of small apo(a) isoforms. Only Lp(a) concentration seemed to comprehensively reflect Lp(a)-associated cardiovascular risk, however.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Roeseler, Eberhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Julius, Ulrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Heigl, Franz UNSPECIFIED UNSPECIFIED UNSPECIFIED Spitthoever, Ralf UNSPECIFIED UNSPECIFIED UNSPECIFIED Heutling, Dennis UNSPECIFIED UNSPECIFIED UNSPECIFIED Breitenberger, Paul UNSPECIFIED UNSPECIFIED UNSPECIFIED Leebmann, Josef UNSPECIFIED UNSPECIFIED UNSPECIFIED Lehmacher, Walter UNSPECIFIED UNSPECIFIED UNSPECIFIED Kamstrup, Pia R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Nordestgaard, Borge G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Maerz, Winfried UNSPECIFIED UNSPECIFIED UNSPECIFIED Noureen, Asma UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Konrad UNSPECIFIED UNSPECIFIED UNSPECIFIED Kronenberg, Florian UNSPECIFIED orcid.org/0000-0003-2229-1120 UNSPECIFIED Heibges, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Klingel, Reinhard UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-263963
DOI:	10.1161/ATVBAHA.116.307983
Journal or Publication Title:	Arterioscler. Thromb. Vasc. Biol.
Volume:	36
Number:	9
Page Range:	S. 2019 - 2028
Date:	2016
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1524-4636
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PROSPECTIVE OBSERVATIONAL MULTICENTER; LIPID-LOWERING THERAPY; OXIDIZED PHOSPHOLIPIDS; MYOCARDIAL-INFARCTION; LDL APHERESIS; RISK; TOLERABILITY; EFFICACY; IMPACT; SAFETY Multiple languages Hematology; Peripheral Vascular Disease Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/26396