Key result
Plasma exchange combined with diet and drug therapy reduced plasma cholesterol levels by 46% and prevented further progression of coronary atheroma over 31 months in a single patient.
Why the study?
Does plasma exchange combined with diet and drug therapy prevent progression of coronary artery atherosclerosis in a patient with homozygous familial hypercholesterolemia?
Case Report (n=1)
No
Does plasma exchange combined with diet and drug therapy prevent progression of coronary artery atherosclerosis in a patient with homozygous familial hypercholesterolemia?
Plasma exchange combined with diet and drug therapy may retard or prevent further progression of coronary atherosclerosis in homozygous familial hypercholesterolemia.
Hypothesis-generating in homozygous FH; leaves open whether plasma exchange alters long-term outcomes.
The effects of plasma exchange performed every two weeks for 31 months in combination with diet and drug therapy were studied in a patient with receptor-defective homozygous familial hypercholesterolemia. Coronary angiography performed three years prior to commencing plasma exchange was compared to angiography 31 months after starting the program. Comparison of the angiograms taken six years apart showed no progression of coronary atheroma in the main left coronary artery in which a 30% narrowing was originally seen. An internal mammary artery-coronary artery bypass remained widely patent and showed no development of atherosclerosis. Plasma cholesterol levels were reduced 46% by plasma exchange, diet and drug compared to diet and drug alone. Achilles tendon xanthoma diminished significantly. It appears that plasma exchange combined with diet and drug therapy, while not producing regression of existing atheromatous lesions, does retard or prevent further progression.
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Stein et al. (1986) conducted a case report in Homozygous familial hypercholesterolemia (n=1). Plasma exchange combined with diet and drug therapy vs. Diet and drug alone was evaluated on Progression of coronary artery atherosclerosis. Plasma exchange combined with diet and drug therapy reduced plasma cholesterol levels by 46% and prevented further progression of coronary atheroma over 31 months in a single patient.
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