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Keywords:

  • Coronary artery disease;
  • Dyslipidemia;
  • Low-density lipoprotein apheresis;
  • Multicenter study

Abstract

A retrospective study—the Italian Multicenter Study on Low-density Lipoprotein Apheresis (IMS-LDLa)—was carried out, which involved 19 centers for LDLa in Italy, distributed all over the country—in the north, center, south, and the major islands. The survey was conducted through two consecutive questionnaires, which can be downloaded online from a dedicated site. The total number of procedures performed until 2007 was 31 012, and the number of patients undergoing treatment until 2007 were 229. The treated patients still surviving consisted of 136 (74 males and 62 females); those surviving but not treated numbered 95, and those deceased numbered 14. The techniques utilized, listed by frequency of use, were the following: dextran sulfate cellulose adsorption, direct adsorption of lipids (DALI), heparin extracorporeal LDL precipitation, immunoadsorption, plasma-exchange, cascade filtration, and Lipocollect 200. The mean treated plasma and blood volumes per session were 3916.5 mL and 8735.1 mL, respectively. The most frequently utilized vascular access points were: venous 84.4% and arteriovenous fistula 15.5%. Hematoma by venipuncture (230 episodes), low outlet flow (125 episodes), and circuit coagulation (44 episodes) were reported as to be the most frequent side effects. In the second questionnaire (filled in by 19 centers) the centers were asked to report their data on: quality diagnosis of dyslipidemia and referents for genetic-molecular and clinical diagnosis, cholesterol-lowering drugs and dosages, typology of cardiovascular check-ups at the beginning of treatment and in follow-up, non-cholesterol-lowering drugs with priority for cardiologic drugs, including oral anti-coagulants, and, lastly, information related to the appropriateness of curing patients still under treatment with LDLa and, where possible, news on patients no longer under treatment.