Сhoice of lipoprotein apheresis method in a patient with a very high cardiovascular risk

Authors: Abramyan M.V., Afanasieva E.A., Esayan G.S., Yarustovskiy M.B., Nazarova E.I.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

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Type:  Clinical Cases


DOI: https://doi.org/10.24022/1997-3187-2023-17-3-433-442

For citation: Abramyan M.V., Afanasieva E.A., Esayan G.A., Yaroustovsky M.B., Nazarova E.I. Сhoice of lipoprotein apheresis method in a patient with a very high cardiovascular risk. Creative Cardiology. 2023; 17 (3): 433–42 (in Russ.). DOI: 10.24022/1997-3187-2023-17-3-433-442

Received / Accepted:  25.08.2023 / 26.09.2023

Keywords: extracorporeal therapy blood purification atherosclerosis hypercholesterolemia hyperLp(a)emia H.E.L.P.-apheresis lipidfiltration double filtration low-density lipoprotein apheresis antithrombin proteins C and S plasminogen plasmin inhibitor

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Abstract

This article will briefly highlight some aspects of extracorporeal blood purification – lipid-double filtration and H.E.L.P.-apheresis in the complex therapy of cardiovascular diseases with concomitant dyslipidemia. This publication presents the experience of treating hypercholesterolemia, hyperlipoprotein(a)emia (hyperLp(a)emia) in a patient with a very high cardiovascular risk. In the presented clinical case, the high efficiency of LDL apheresis for elevated low-density lipoprotein (LDL) and lipoprotein(a) and a justified choice of method was shown. To date, there are no specific criteria for choosing an apheresis procedure. We have found that LDL apheresis techniques have different effects on the activity of the hemostasis system (activities of antithrombin, proteins C and S, plasminogen, plasmin inhibitor). The assessment of the effect of apheresis procedures on hematological and hemostatic parameters in our observation, on the one hand, showed safety and efficacy, and on the other hand, served as the basis for a personalized choice of a particular LDL apheresis technique.

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About Authors

  • Marina V. Abramyan, Cand. Med. Sci., Leading Researcher, Transfusiologist; ORCID
  • Ekaterina A. Afanasieva, Cand. Med. Sci., Head of Laboratory; ORCID
  • Galina S. Esayan, Junior Researcher; ORCID
  • Mikhail B. Yarustovskiy, Dr. Med. Sci., Professor, Corresponding Member of RAS, Deputy Director, Head of Department; ORCID
  • Elena I. Nazarova, Transfusiologist; ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery