Coronary atherosclerosis reduced in patients with familial hypercholesterolemia after intensive cholesterol lowering with low-density lipoprotein-apheresis: 1-year follow-up study

A. Kitabatake, H. Sato, M. Hori, T. Kamada, S. Kubori, N. Hoki, T. Minamino, M. Yamada, T. Kato, H. Yokoyama, H. Ozaki, M. Inoue, O. Tojo, K. Okamura, M. Fukunami, H. Ito, T. Maeda

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Abstract

To test the hypothesis that aggressive cholesterol lowering results in a rapid regression of coronary atherosclerosis, the effect of low-density lipoprotein (LDL)-apheresis for 1 year on coronary artery diameters was studied in patients with heterozygous familial hypercholesterolemia. LDL-apheresis was performed every 2 weeks in 13 patients with LDL-cholesterol levels ≥ 200 mg/dL despite treatment with conventional dietary and drug therapies. Coronary arteriography was performed before and 1 year after the initiation of treatment. The LDL-cholesterol level was decreased by an average of 71% immediately after the initial LDL-apheresis and by 30% before the second apheresis. Such phasic changes were observed throughout the trial. Computer-assisted automated quantitative arteriograms analyzed 101 proximal coronary segments. The mean lumen diameter of angiographically normal sections of each segment was slightly but significantly increased from 2.93 ± 0.89 mm at baseline to 3.05 ± 0.93 mm at the follow-up arteriogram (P < 0.05); 54 of the 101 segments showed a lesion stenosed by 20% or more in diameter. The minimal diameter of individual lesions was also significantly increased form 2.17 ± 0.67 mm to 2.36 ± 0.76 mm (P < 0.05), and thus the diameter stenosis was significantly reduced from 32.3 ± 10.5% to 28.2 ± 12.1% (P < 0.05). It is concluded that 1 year of aggressive cholesterol lowering, using LDL-apheresis, can significantly reduce coronary atherosclerosis in patients with familial hypercholesterolemia.

Original languageEnglish
Pages (from-to)416-428
Number of pages13
JournalClinical Therapeutics
Volume16
Issue number3
Publication statusPublished - Oct 25 1994
Externally publishedYes

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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    Kitabatake, A., Sato, H., Hori, M., Kamada, T., Kubori, S., Hoki, N., Minamino, T., Yamada, M., Kato, T., Yokoyama, H., Ozaki, H., Inoue, M., Tojo, O., Okamura, K., Fukunami, M., Ito, H., & Maeda, T. (1994). Coronary atherosclerosis reduced in patients with familial hypercholesterolemia after intensive cholesterol lowering with low-density lipoprotein-apheresis: 1-year follow-up study. Clinical Therapeutics, 16(3), 416-428.