Prevention of cardiovascular complications in patients with Lp(a)-hyperlipoproteinemia and progressive cardiovascular disease by long-term lipoprotein apheresis according to German national guidelines

Figures

• 

  Fig. 1. Clinical course of patients with progressive CVD associated with Lp(a)-HLP in the Pro(a)LiFe study. Mean annual rates of MACE (major adverse cardiac event, i. e. cardiovascular death, nonfatal myocardial infarction, coronary bypass surgery, percutaneous coronary intervention,or stent) in dark orange bars. Light orange bars depict MACE plus disease progression detected by imaging techniques accounted as equivalent event. Progression of CVD without clinical event was accounted as equivalent event with the following findings: incidence of new or additional CVD at a new vascular location or region, or deterioration of existing CVD, e. g. 2‑vessel CAD progressed to 3‑vessel CAD, new appearance of stenosis or plaques within an already affected vessel or vessel region, >20% deterioration of existing stenosis, appearance of in-stent stenosis, or stenosis in artery bypass. MACE, major adverse cardiac event; CVD, cardiovascular disease; LA, lipoprotein apheresis; Lp(a)-HLP, Lp(a)-hyperlipoproteinemia

• 

  Fig. 2. Frequency of the small (≤22 KIV domain copies) apo(a) allele genotype, or high risk allele variants tagged by SNPs rs41055872 or rs3798220 [13], and corresponding mean Lp(a) concentrations (modified from [1])

• 

  Fig. 3. Lp(a) levels of Pro(a)LiFe patients in mg/dl (136 patients with available K4 domain PCR data) and in nmol/l (134 patients with available isoform specific Lp(a) concentration) after conversion with KIV/2 copy repeat number specific conversion factors according to percentage contribution of isoforms to patients’ total Lp(a). Conversion factors were calculated based on the following assumptions: (1) constant lipid composition of LDL particles, (2) Lp(a) total protein consists of apoB of 513 kDa and apo(a) with a molecular weight varying according to the K4 domain number, (3) composition of Lp(a) except 22% protein (apoB), 5% carbohydrate, 8% unesterified cholesterol, 38% cholesterol ester, 20% phospholipid, 7% triglyzeride (Preparation methods according to [14]). Resulting isoform specific conversion factors from mg/dl to nmol/l listed in the format “kringel 4 domain number”/“apo(a) size in kDa”/“conversion factor” (courtesy of S. Marcovina by personal communication): 12/700/2.75; 13/712/2.70; 14/725/2.65; 15/737/2.61; 16/750/2.56; 17/762/2.52; 18/775/2.48; 19/787/2.44; 20/800/2.40; 21/812/2.37; 22/825/2.33; 23/837/2.30; 24/850/2.26; 25/862/2.23; 26/875/2.20; 27/887/2.17;…