First Steps Toward the Establishment of a German Low-Density Lipoprotein-Apheresis Registry: Recommendations for the Indication and for Quality Management

• Published in: Therapeutic apheresis Vol. 6; no. 5; pp. 381 - 383
• Main Authors: Schettler, V., Wieland, E., Armstrong, V.W., Kleinoeder, T., Grunewald, R.W., Müller, G.A.
• Format: Journal Article
• Language: English
• Published: Boston, MA, USA Blackwell Science Inc 01.10.2002
• Subjects: Apheresis registry; Cholesterol, LDL - blood; Consensus Development Conferences as Topic; Coronary Disease - prevention & control; Germany; Humans; Hypercholesterolemia; Indication for low-density lipoprotein apheresis; Low-density lipoprotein apheresis; Practice Guidelines as Topic; Program Development; Registries; Germany
• ISSN: 1091-6660; 1526-0968
• DOI: 10.1046/j.1526-0968.2002.00426.x

: New recommendations for the indication of treatment with selective extracorporeal plasma therapy low‐density lipoprotein apheresis (LDL‐apheresis) in the prevention of coronary heart disease are urgently needed. The following points are the first results of the ongoing discussion process for indications for LDL‐apheresis in Germany: all patients with homozygous familial hypercholesterolemia with functional or genetically determined lack or dysfunction of LDL receptors and plasma LDL cholesterol levels >13.0 mmol/L (>500 mg/dL); patients with coronary heart disease (CHD) documented by clinical symptoms and imaging procedures in which over a period of at least 3 months the plasma LDL cholesterol levels cannot be lowered below 3.3 mmol/L (130 mg/dL) by a generally accepted, maximal drug‐induced and documented therapy in combination with a cholesterol‐lowering diet; and patients with progression of their CHD documented by clinical symptoms and imaging procedures and repeated plasma Lp(a) levels >60 mg/dL, even if the plasma LDL cholesterol levels are lower than 3.3 mmol/L (130 mg/dL). Respective goals for LDL cholesterol concentrations for high‐risk patients have been recently defined by various international societies. To safely put into practice the recommendations for LDL‐apheresis previously mentioned, standardized treatment guidelines for LDL‐apheresis need to be established in Germany that should be supervised by an appropriate registry.