Changes in plasma lipid and apolipoprotein levels between heparin-induced extracorporeal low-density lipoprotein precipitation (HELP) treatments

doi:10.1016/S0002-9149(99)80743-7

The American Journal of Cardiology

Volume 75, Issue 16, 1 June 1995, Pages 1124-1129

https://doi.org/10.1016/S0002-9149(99)80743-7 Get rights and content

Abstract

Heparin-induced extracorporeal low-density lipoprotein (LDL) precipitation (HELP) treatments selectively remove LDL with minimal effects on high-density lipoproteins (HDL), but limited data are available on effects between treatments. The levels of factors associated with increased coronary artery disease risk (atherogenic) among treatments may nave therapeutic significance, especially for combined HELP and lipid-lowering drug therapy. Hypercholesterolemic and combined hyperlipidemic patients resistant to diet/drug therapy were treated with biweekly HELP therapy. Hypercholesterolemic patients received either lovastatin or no drug, whereas combined hyperlipidemic patients received gemfibrozil. Plasma lipid (total cholesterol, triglycerides, LDL cholesterol, and HDL cholesterol) and apolipoprotein A-I, A-II, B, C-III, and E levels were measured before treatment, then immediately, and 2, 4, 7, and 14 days after treatments (n = 28). Atherogenic factor (LDL cholesterol, total cholesterol, apolipoprotein B) levels decreased > 50% with treatment, gradually increasing over 14 days to pretreatment levels. Factors associated with reduced coronary artery disease risk (HDL cholesterol and apolipoproteins A-I and A-II) decreased 8% to 16% but recovered by 2 days. Components of triglyceriderich lipoproteins (triglycerides and apolipoproteins C-III and E) decreased 38% to 55% with variable post-treatment recoveries. Lovastatin reduced pretreatment levels of atherogenic and triglyceride-rich lipoprotein components and slowed post-treatment increases compared with no drug therapy. Gemfibrozil produced changes similar to lovastatin. Drug therapy had little effect on factors associated with reduced coronary artery disease risk. HELP apheresis produced large reductions in plasma atherogenic factor levels with gradual return to pretreatment levels over 14 days, whereas antiatherogenic factors were minimally reduced and recovered rapidly. Lipid-lowering drug therapy reduced pretreatment levels and delayed post-treatment increases of both cholesterol-and triglyceride-rich lipoproteins.

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: This study was supported in part by resources from the Oklahoma Medical Research Foundation and the Presbyterian Health Foundation, Oklahoma City, Oklahoma, and B. Braun of America, Inc., Bethlehem, Pennsylvania.

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Changes in plasma lipid and apolipoprotein levels between heparin-induced extracorporeal low-density lipoprotein precipitation (HELP) treatments

Abstract

Atherosclerosis

Am J Cardiol

Atherosclerosis

Am J Cardiol

Am J Cardiol

Report of the National Cholesterol Education Program Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults

Arch Intern Med

Lipoproteins and atherogenesis. Current concepts

JAMA

Quantitation of plasma apolipoproteins in the primary and secondary prevention of coronary artery disease

Ann Intern Med

Summary of the Second Report of the National Cholesterol Education Program (NCEP) Expert Panel on detection, evaluation and treatment of high blood cholesterol in adults (Adult Treatment Panel II)

JAMA