LOS ANGELES (August 26, 1999) -- For patients with extremely high LDL cholesterol (also called "bad cholesterol") that does not respond to treatment, Cedars-Sinai has become the first site in California to offer LDL apheresis, a system approved for treatment by the Food and Drug Administration earlier this year.
"Its indications are limited to patients with severe hypercholesterolemia who have not responded to standard therapy, says Timothy A. Denton, M.D., attending cardiologist. "The majority of patients are homozygous and heterozygous familial hypercholesterolemics, or patients who have been tried on at least two cholesterol-lowering agents, but whose LDL cholesterol still remains greater than 200."
According to Dr. Denton, the two- to four-hour therapy usually must be performed one or two times per month for the remainder of a patient's life. Researchers hope, however, that advances in drug therapy may someday allow the frequency of treatments to be reduced.
The technique is similar to plasmapheresis. Blood is separated into plasma and red cells, with the red cells being passed immediately back to the patient. Before the remaining plasma is returned to the patient, it is run through a column that specifically removes LDL cholesterol.
"The concept has existed for 20 years or so but it has become more effective and popular now because of computers and miniaturization. We can perform the procedure and reduce LDL levels very, very effectively now. In fact, dramatic reductions in LDL can be seen with commensurate improvement in cardiovascular outcomes," said Dr. Dennis Goldfinger, Director of Transfusion Medicine -- the section of the hospital that performs the procedure.
For example, studies reported in the medical literature have demonstrated that LDL apheresis can induce the regression of atherosclerosis, improve cardiac perfusion in patients with coronary artery disease, and decrease coronary events in a variety of patients.
While the majority of patients can control LDL levels through a combination of diet, exercise and drugs, LDL apheresis can be considered a potentially life-saving therapy when all else fails.
"The addition of LDL apheresis provides Cedars-Sinai patients with all available technologies for cholesterol management," says P.K. Shah, M.D., Director of Cedars-Sinai’s Division of Cardiology, noting that this technology is available at only 21 sites in the United States.
To determine whether LDL apheresis may be helpful and appropriate in a specific case, a formal screening process is in place to review medical records and perform physical assessments of potential candidates. For additional information about the procedure or to determine if this might be an appropriate treatment option for a patient, call the LDL apheresis center at (310) 967-1861.
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