Effect of HELP‐LDL‐apheresis on serum concentrations of human lipoprotein(a): kinetic analysis of the post‐treatment return to baseline levels

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Abstract
In addition to LDL, Lp(a) can be quantitavely eliminated from plasma in an extracorporeal LDL‐apheresis procedure based on precipitation with heparin at pH 5.12. The rates of return of postapheresis Lp(a) and LDL‐cholesterol concentrations to baseline levels were investigated in six individuals with familial hypercholesterolaemia (one homozygote, five heterozygote) and one normolipaemic individual. The first‐order disappearance constants (k) were derived for LDL and Lp(a) according to Apstein et al. [1]. The k values for LDL in the homozygous FH and the normolipaemic individual were 0.082 and 0.43 respectively while the heterozygous FH patients had k values intermediate between the two (median 0.231; range 0.116–0.261). The first‐order disappearance constants of Lp(a) did not correlate with those of LDL. The homozygous FH and normolipaemic individuals had Lp(a) k values of 0.158 and 0.199 respectively; the corresponding values in the heterozygous FH patients were: median 0.142; range 0.045–0.179.