Key result
LDL apheresis plus drug therapy preserves SVG patency for 14 years in one FH patient.
Why the study?
The long-term effect of LDL apheresis combined with drug therapy on preventing occlusion of saphenous vein bypass grafts in heterozygous familial hypercholesterolemia with type 2 diabetes mellitus was not well established.
Does LDL apheresis combined with drug therapy prevent occlusion of bypass grafts in a patient with heterozygous familial hypercholesterolemia and type 2 diabetes mellitus?
Case Report (n=1)
Does LDL apheresis combined with drug therapy prevent occlusion of bypass grafts in a patient with heterozygous familial hypercholesterolemia and type 2 diabetes mellitus?
Long-term LDL apheresis combined with drug therapy may be highly effective in preventing saphenous vein graft occlusion in patients with heterozygous familial hypercholesterolemia.
Answers are grounded in this paper and cite their sources.
Hypothesis-generating for LDL apheresis plus drugs in heterozygous FH post-CABG; prospective trials needed before practice change.
A 61-year-old Japanese woman with heterozygous familial hypercholesterolemia (FH), type 2 diabetes mellitus and coronary artery disease underwent coronary artery bypass grafting (CABG) utilizing a saphenous vein graft at the age of 46, in June 1984, 6 months before low density lipoprotein (LDL) apheresis was started. She had received LDL apheresis every two weeks, along with combined drug treatment since the age of 47 (December 1984). She had bilateral xanthelasma and Achilles tendon xanthomas. Her fasting baseline serum total cholesterol and triglyceride level were 464 mg/dl and 57 mg/dl, respectively at the age of 47 when she visited our hospital for the first time. Analysis of the genomic DNA from the patient revealed heterozygous amino acid substitution of Leu for Pro664 in the LDL receptor gene. She was diagnosed as type 2 diabetes mellitus at the age of 53. Combined treatment in the steady state yielded a pretreatment LDL cholesterol level of 230+/-14 mg/dl and a posttreatment level of 57+/-7.6. All grafts were widely patent after as long as 14 years since CABG, suggesting that LDL apheresis combined with drug therapy is highly effective in preventing the occlusion of bypass grafts in a patient with heterozygous FH and type 2 diabetes mellitus.
No takes yet. Share an insight, caveat, or question.
Takahashi et al. (2000) conducted a case report in Heterozygous familial hypercholesterolemia and coronary artery disease (n=1). LDL apheresis combined with drug therapy was evaluated on Patency of aortocoronary saphenous-vein bypass grafts. LDL apheresis combined with drug therapy maintained wide patency of all aortocoronary saphenous-vein bypass grafts for 14 years in a patient with heterozygous familial hypercholesterolemia.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: