Who should be treated for Lipoprotein Apheresis?

HEART UK guidelines^* recommend that Lipoprotein Apheresis should be the treatment of choice for:

1. All FH homozygotes from the age of 7 onwards unless their serum cholesterol can be reduced by >50% and/or decreased to <9 mmol/L by drug therapy.
2. Patients with heterozygous FH or a family history of premature cardiac death who have progressive coronary disease and where LDL-C is <5.0 mmol/L or is decreased by <40% with maximal drug therapy.
3. Apheresis should be considered for patients with aggressive and progressing coronary disease with Lp(a) >600 mg/L and LDL-C >3.2 mmol/L, despite maximal drug therapy.

NICE guidance recommends that apheresis should be considered for treatment of patients with heterozygous FH who have symptomatic, progressive coronary disease, despite optimal medical and surgical therapy

*Thompson G et al, Atherosclerosis (2008) 247-55