Key result
Regular lipoprotein apheresis was associated with a 78% reduction in major coronary events during the first 2 years of treatment compared to the 2 years prior to treatment.
Why the study?
Does regular lipoprotein apheresis reduce major coronary events in patients with progressive ASCVD and high LDL-C or Lp(a) despite maximal medical therapy?
Observational (n=2,028)
Yes
Does regular lipoprotein apheresis reduce major coronary events in patients with progressive ASCVD and high LDL-C or Lp(a) despite maximal medical therapy?
Effect estimate: 78% reduction
Regular lipoprotein apheresis is associated with a 78% reduction in major coronary events and significant reductions in LDL-C and Lp(a) in high-risk patients.
Supports LA investigation in refractory ASCVD; hypothesis-generating and should not change practice without RCTs.
During 2012-2020, 89 German apheresis centers collected retrospective and prospective observational data of 2028 patients undergoing regular lipoprotein apheresis (LA) for the German Lipoprotein Apheresis Registry (GLAR). More than 47 500 LA sessions are documented in GLAR. In 2020, all patients treated with LA showed a high immediate median reduction rate of LDL-C (68.2%, n = 1055) and Lp(a) (72.4%, n = 994). Patient data were analyzed for the incidence rate of major coronary events (MACE) 1 and 2 years before the beginning of LA treatment (y-2 and y-1) and prospectively up to 7 years on LA (y + 1 to y + 7). During the first 2 years of LA (y + 1 and y + 2), a MACE reduction of 78% was observed. Current analysis of GLAR data shows very low incidence rates of cardiovascular events in patients with high LDL-C and/or high Lp(a) levels, progressive ASCVD, and maximally tolerated lipid lowering medication regular by LA results.
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Schettler et al. (2022) conducted an observational in Progressive ASCVD with high LDL-C and/or high Lp(a) levels (n=2,028). Regular lipoprotein apheresis vs. 1 and 2 years prior to the beginning of treatment was evaluated on Major coronary events (MACE) (78% reduction). Regular lipoprotein apheresis was associated with a 78% reduction in major coronary events during the first 2 years of treatment compared to the 2 years prior to treatment.
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