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Cited by 227Lipoproteins and Cardiovascular HealthLipid metabolism and disordersAtherosclerosis and Cardiovascular Diseases

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Lipoprotein Apheresis for Lipoprotein(a)-Associated Cardiovascular Disease: Prospective 5 Years of Follow-Up and Apolipoprotein(a) Characterization

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Roeseler, Eberhard, Julius, Ulrich, Heigl, Franz, Spitthoever, Ralf, Heutling, Dennis, Breitenberger, Paul, Leebmann, Josef, Lehmacher, Walter, Kamstrup, Pia R., Nordestgaard, Børge G., Maerz, Winfried, Noureen, Asma, Schmidt, Konrad, Kronenberg, Florian, Heibges, Andreas, Klingel, Reinhard, Schettler, Volker, Benzing, Thomas, Christ, Hildegard, Wehner, Sabine, Schulz-Merkel, Ines, Kuehn, Ralf, Wagner, Albrecht, Dschietzig, Wilfried, Ernst, Claudia, Koziolek, Michael, Bunia, Johannes, Kulzer, Peter, Kraenzle, Klaus-Dieter, Toelle, Markus, Riechers, Gerhard, Kuehnel, Christine, Marsen, Tobias, Saehn, Christina, Ringel, Jens, Messner, Harald, Oehring, Andreas, Schuerfeld, Carsten, Wintergalen, Michael, Schettler, Volker, Neumann, Falko, Kaul, Harald, Haesner, Martin, Passfall, Juergen, Benschneider, Andrea, Heidenreich, Stefan, März, Winfried, Klaes, Ruediger, Binner, Priska, Dieplinger, Hans, Erhart, Gertraud, Fassbender, Cordula, Christ, Hildegard·2016·Arteriosclerosis, Thrombosis, and Vascular Biology
DOI 10.1161/atvbaha.116.307983
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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 0.58±0.53 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.

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Authors
Roeseler, E., Julius, U., Heigl, F., Spitthoever, R., Heutling, D., Breitenberger, P., Leebmann, J., Lehmacher, W., Kamstrup, P. R., Nordestgaard, B. G., Maerz, W., Noureen, A., Schmidt, K., Kronenberg, F., Heibges, A., Klingel, R., Schettler, V., Benzing, T., Christ, H., Wehner, S., Schulz-Merkel, I., Kuehn, R., Wagner, A., Dschietzig, W., Ernst, C., Koziolek, M., Bunia, J., Kulzer, P., Kraenzle, K.-D., Toelle, M., Riechers, G., Kuehnel, C., Marsen, T., Saehn, C., Ringel, J., Messner, H., Oehring, A., Schuerfeld, C., Wintergalen, M., Schettler, V., Neumann, F., Kaul, H., Haesner, M., Passfall, J., Benschneider, A., Heidenreich, S., März, W., Klaes, R., Binner, P., Dieplinger, H., Erhart, G., Fassbender, C., & Christ, H.
Affiliations
  • Technische Universität Dresden (DE)
  • From the Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital at the Technische Universität, Dresden, Germany (U.J.); Medical Health and Care Center Kempten-Allgäu, Kempten, Germany (F.H.); Dialysis and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); 1st Medical Clinic, General Hospital, Passau, Germany (J.L.);...
  • Cologne
  • Hannover
  • Kempten
  • Tangermuende
  • Trier
  • Cottbus
  • Goettingen
  • Iserlohn
  • Marktheidenfeld
  • Memmingen
  • Berlin
  • Braunschweig
  • Krefeld
  • Potsdam
  • Wuppertal
  • Suhl
  • Saarlouis
  • Olpe
  • Dresden
  • Deggendorf
  • Aachen
  • Mannheim
  • Innsbruck, Austria
ORCID
Venue
Arteriosclerosis, Thrombosis, and Vascular Biology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2016-09
Volume
36
Issue
9
Pages
2019-2027
ISSN
  • 1079-5642 (ISSN-L)
  • 1524-4636
DOI
10.1161/atvbaha.116.307983
OpenAlex
W2556080334
Semantic Scholar
012bba31547ed986fa3a0e3d76102f0991dd9ee5
Cited by
227
References
32
Citations by year
2026: 18 · 2025: 15 · 2024: 21 · 2023: 32 · 2022: 20 · 2021: 20 · 2020: 16 · 2019: 36 · 2018: 16 · 2017: 30 · 2016: 2
FWCI
30.97
Type
journal article
Language
en
Open access
Locations
  • Arteriosclerosis Thrombosis and Vascular Biology (publishedVersion)
  • PubMed (publishedVersion)
  • Kölner Universitäts PublikationsServer (Universität zu Köln) (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
  • Life Sciences › Immunology and Microbiology › Immunology › Atherosclerosis and Cardiovascular Diseases
Keywords
lipoprotein apheresis, apolipoprotein(a), cardiovascular disease prevention, cardiovascular events, apolipoprotein(a) isoforms, rs10455872, rs3798220, cardiovascular risk, LDL cholesterol
MeSH terms
Aged, Blood Component Removal, Cardiovascular Diseases, Female, Follow-Up Studies, Germany, Humans, Hyperlipoproteinemias, Male, Middle Aged, Phenotype, Prospective Studies, Risk Factors, Time Factors, Biomarkers, Incidence, Treatment Outcome, Lipoprotein(a), Risk Assessment, Genetic Predisposition to Disease, Polymorphism, Single Nucleotide, Apoprotein(a)

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