{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T22:33:55Z","timestamp":1792103635086,"version":"4.4.0"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2013,12,17]]},"abstract":"<jats:sec>\n                    <jats:title>Background\u2014<\/jats:title>\n                    <jats:p>Lipoprotein(a) (Lp(a)) hyperlipoproteinemia is a major risk factor for cardiovascular disease, which is not affected by treatment of other cardiovascular risk factors. This study sought to assess the effect of chronic lipoprotein apheresis (LA) on the incidence of cardiovascular events in patients with progressive cardiovascular disease receiving maximally tolerated lipid-lowering treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results\u2014<\/jats:title>\n                    <jats:p>\n                      In a prospective observational multicenter study, 170 patients were investigated who commenced LA because of Lp(a)-hyperlipoproteinemia and progressive cardiovascular disease. Patients were characterized regarding plasma lipid status, lipid-lowering drug treatment, and variants at the LPA gene locus. The incidence rates of cardiovascular events 2 years before (y-2 and y-1) and prospectively 2 years during LA treatment (y+1, y+2) were compared. The mean age of patients was 51 years at the first cardiovascular event and 57 years at the first LA. Before LA, mean low-density lipoprotein cholesterol and Lp(a) were 2.56\u00b11.04 mmol\u00b7L\n                      <jats:sup>\u22121<\/jats:sup>\n                      (99.0\u00b140.1 mg\u00b7dL\n                      <jats:sup>\u22121<\/jats:sup>\n                      ) and Lp(a) 3.74\u00b11.63 \u00b5mol\u00b7L\n                      <jats:sup>\u22121<\/jats:sup>\n                      (104.9\u00b145.7 mg\u00b7dL\n                      <jats:sup>\u22121<\/jats:sup>\n                      ), respectively. Mean annual rates for major adverse coronary events declined from 0.41 for 2 years before LA to 0.09 for 2 years during LA (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001). Event rates including all vascular beds declined from 0.61 to 0.16 (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001). Analysis of single years revealed increasing major adverse coronary event rates from 0.30 to 0.54 (\n                      <jats:italic>P<\/jats:italic>\n                      =0.001) for y-2 to y-1 before LA, decline to 0.14 from y-1 to y+1 (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001) and to 0.05 from y+1 to y+2 (\n                      <jats:italic>P<\/jats:italic>\n                      =0.014).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>In patients with Lp(a)-hyperlipoproteinemia, progressive cardiovascular disease, and maximally tolerated lipid-lowering medication, LA effectively lowered the incidence rate of cardiovascular events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/drks-neu.uniklinik-freiburg.de\">https:\/\/drks-neu.uniklinik-freiburg.de<\/jats:ext-link>\n                      . Unique identifier: DRKS00003119.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.113.002432","type":"journal-article","created":{"date-parts":[[2013,9,21]],"date-time":"2013-09-21T02:12:01Z","timestamp":1379729521000},"page":"2567-2576","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":303,"title":["Lipoprotein Apheresis in Patients With Maximally Tolerated Lipid-Lowering Therapy, Lipoprotein(a)-Hyperlipoproteinemia, and Progressive Cardiovascular Disease"],"prefix":"10.1161","volume":"128","author":[{"given":"Josef","family":"Leebmann","sequence":"first","affiliation":[{"name":"From the 1st Medical Clinic, General Hospital, Passau, Germany (J.L.); Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital, Dresden, Germany (U.J.); MVZ Kempten-Allgaeu, Kempten, Germany (F.H.); Dialysis- and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); Institute of Public Health and Preventive Medicine,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eberhard","family":"Roeseler","sequence":"additional","affiliation":[{"name":"From the 1st Medical Clinic, General Hospital, Passau, Germany (J.L.); Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital, Dresden, Germany (U.J.); MVZ Kempten-Allgaeu, Kempten, Germany (F.H.); Dialysis- and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); Institute of Public Health and Preventive Medicine,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Julius","sequence":"additional","affiliation":[{"name":"From the 1st Medical Clinic, General Hospital, Passau, Germany (J.L.); Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital, Dresden, Germany (U.J.); MVZ Kempten-Allgaeu, Kempten, Germany (F.H.); Dialysis- and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); Institute of Public Health and Preventive Medicine,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franz","family":"Heigl","sequence":"additional","affiliation":[{"name":"From the 1st Medical Clinic, General Hospital, Passau, Germany (J.L.); Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital, Dresden, Germany (U.J.); MVZ Kempten-Allgaeu, Kempten, Germany (F.H.); Dialysis- and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); Institute of Public Health and Preventive Medicine,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Spitthoever","sequence":"additional","affiliation":[{"name":"From the 1st Medical Clinic, General Hospital, Passau, Germany (J.L.); Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital, Dresden, Germany (U.J.); MVZ Kempten-Allgaeu, Kempten, Germany (F.H.); Dialysis- and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); Institute of Public Health and Preventive Medicine,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis","family":"Heutling","sequence":"additional","affiliation":[{"name":"From the 1st Medical Clinic, General Hospital, Passau, Germany (J.L.); Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital, Dresden, Germany (U.J.); MVZ Kempten-Allgaeu, Kempten, Germany (F.H.); Dialysis- and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); Institute of Public Health and Preventive Medicine,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Breitenberger","sequence":"additional","affiliation":[{"name":"From the 1st Medical Clinic, General Hospital, Passau, Germany (J.L.); Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital, Dresden, Germany (U.J.); MVZ Kempten-Allgaeu, Kempten, Germany (F.H.); Dialysis- and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); Institute of Public Health and Preventive Medicine,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Winfried","family":"Maerz","sequence":"additional","affiliation":[{"name":"From the 1st Medical Clinic, General Hospital, Passau, Germany (J.L.); Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital, Dresden, Germany (U.J.); MVZ Kempten-Allgaeu, Kempten, Germany (F.H.); Dialysis- and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); Institute of Public Health and Preventive Medicine,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Lehmacher","sequence":"additional","affiliation":[{"name":"From the 1st Medical Clinic, General Hospital, Passau, Germany (J.L.); Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital, Dresden, Germany (U.J.); MVZ Kempten-Allgaeu, Kempten, Germany (F.H.); Dialysis- and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); Institute of Public Health and Preventive Medicine,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Heibges","sequence":"additional","affiliation":[{"name":"From the 1st Medical Clinic, General Hospital, Passau, Germany (J.L.); Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital, Dresden, Germany (U.J.); MVZ Kempten-Allgaeu, Kempten, Germany (F.H.); Dialysis- and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); Institute of Public Health and Preventive Medicine,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinhard","family":"Klingel","sequence":"additional","affiliation":[{"name":"From the 1st Medical Clinic, General Hospital, Passau, Germany (J.L.); Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital, Dresden, Germany (U.J.); MVZ Kempten-Allgaeu, Kempten, Germany (F.H.); Dialysis- and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); Institute of Public Health and Preventive Medicine,..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1063"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/atvbaha.112.255521"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2009.12.036"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq386"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.2217\/bmm.11.60"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0902604"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2009.06.010"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11789-012-0046-6"},{"key":"e_1_3_3_10_2","first-page":"3321","article-title":"German Federal Ministry of Health. Publication of a decision of Federal Joint Committee on apheresis for isolated Lp(a)-elevation with progressive cardiovascular disease.","volume":"138","year":"2008","unstructured":"German Federal Ministry of Health. Publication of a decision of Federal Joint Committee on apheresis for isolated Lp(a)-elevation with progressive cardiovascular disease. Transactions of the German Federal Ministries (BAnz). 2008; 138: 3321.","journal-title":"Transactions of the German Federal Ministries (BAnz)"},{"key":"e_1_3_3_11_2","first-page":"229","article-title":"Longitudinal cohort study on the effectiveness of lipid apheresis treatment to reduce high lipoprotein(a) levels and prevent major adverse coronary events.","volume":"6","author":"Jaeger BR","year":"2009","unstructured":"Jaeger BR, Richter Y, Nagel D, Heigl F, Vogt A, Roeseler E, Parhofer K, Ramlow W, Koch M, Utermann G, Labarrere CA, Seidel D; Group of Clinical Investigators. Longitudinal cohort study on the effectiveness of lipid apheresis treatment to reduce high lipoprotein(a) levels and prevent major adverse coronary events. Nat Clin Pract Cardiovasc Med. 2009;6:229\u2013239.","journal-title":"Nat Clin Pract Cardiovasc Med"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0021-9150(00)00371-3"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2008.02.009"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1038\/330132a0"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCGENETICS.110.958371"},{"key":"e_1_3_3_16_2","unstructured":"National Association of Statutory Health Insurance Physicians. KBV-Annual quality report 2011 and 2012. http:\/\/www.kbv.de\/presse\/6793.html(in German). Accessed August 30 2013."}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.113.002432","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T03:03:24Z","timestamp":1715569404000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.113.002432"}},"subtitle":["Prospective Observational Multicenter Study"],"short-title":[],"issued":{"date-parts":[[2013,12,17]]},"references-count":15,"journal-issue":{"issue":"24","published-print":{"date-parts":[[2013,12,17]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.113.002432"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.113.002432","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,12,17]]},"assertion":[{"value":"2013-03-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-09-10","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-09-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}