Apheresis methods in hyperlipidemias

Abstract

Familial hypercholesterolemia (FH) is a well-known genetic disorder characterized by elevated levels of low-density lipoprotein cholesterol (LDL-C). This leads to the accelerated status of atherosclerotic vascular disease with expected premature onset of coronary heart disease (CHD). Atherosclerosis with myocardial infarction and stroke are still the most common causes of mortality and morbidity worldwide. Drug therapy, cardiovascular surgery, and early diagnostic techniques have limited effectiveness on reducing the mortality rates. Arterial hypertension, smoking, diabetes mellitus, and obesity are the additional risk factors for the progression of CHD. A wide spectrum of treatment strategies (liver transplantation, partial ileal bypass, portocaval shunt, gene therapy, and plasmapheresis) have been developed to achieve better outcomes on hypercholesterolemia. Despite the fact that all these options had important morbidity attached to each other, selective low-density lipoprotein (LDL) apheresis has been considered as the most promising strategy in the treatment era. This chapter will focus on the techniques and outcomes of LDL-apheresis strategies on FH that could significantly improve patient prognosis.