Prospective observational study on the clinical efficacy of lipid-apheresis in patients with elevated lipoprotein(a)


Lipoprotein(a) is recognized as independent and causal risk factor for cardiovascular disease and cardiovascular complications. The prospective multicenter observational study Pro(a)-Life was initiated by the Apheresis Research Institute. After sample size calculation 170 patients were enrolled from 28 treatment centers throughout Germany. They started with chronic lipid apheresis therapy after approval by the apheresis committee of the regional association of statutory health insurance physicians, or directly by the individual statutory or private health insurance fund according to German reimbursement guidelines. The aim of Pro(a)-Life was to assess the efficacy of lipid-apheresis in high-risk patients with elevated Lp(a) >60 mg/dl and a progressive cardiovascular disease by analysis of the event rates MACE (Major Adverse Coronary Events) and ACVE (Adverse Cardiac or Vascular Events).

The Pro(a)-Life study demonstrated the clinical efficacy of lipid-apheresis with isolated elevated Lp(a) and progressive vascular disease (Leebmann 2013). The impressive 2-year data have already been published in the high-ranked cardiology journal Circulation. Analysis of 5-year data has been completed recently and will be published soon. The mean age of patients at the first cardiovascular event (85% cardiac) was 51 years and 57 years at time of first lipid-apheresis treatment. The reduction rates for Lp(a) and LDL cholesterol were on average at 60-70% per lipid-apheresis treatment. The average lipoprotein(a) levels before commencing chronic lipid apheresis were at 105 mg/dl. The LDL cholesterol levels were on average 99 mg/dl.

The risk of cardiovascular complications was significantly reduced in all patients. The average rate of cardiovascular events (MACE per year) decreased by 78% from 0.41 in the two years prior to apheresis to 0.09 in the first two years under chronic apheresis treatment (p<0.0001). The event rate in all vessel regions (ACVE per year) decreased by 76% from 0.58 to 0.14 (p <0.0001). The number of cerebrovascular events, largely strokes, was reduced by 80%. The number of peripheral vascular events, mainly bypasses and stents of the lower extremities, was reduced by 63%.

¹Pro(a)-Life - Prospective documentation of isolated lipoprotein(a) elevation with progressive cardiovascular disease and lipoprotein apheresis for effective treatment of hyperlipoproteinemia

For more information on Pro(a)-Life study please feel free to contact the Apheresis Research Institute.

Further reading

  • Leebmann J, Roeseler E, Julius U et al. Lipoprotein apheresis in patients with maximally tolerated lipid-lowering therapy, lipoprotein(a)-hyperlipoproteinemia, and progressive cardiovascular disease - Prospective observational multicenter study. Circulation (2013) 128: 2567-2576. Abstract
  • Roeseler E, Julius U, Heigl F et al. Lipoprotein apheresis for Lipoprotein(a)-associated cardiovascular disease: Prospective 5 years of follow-up and apolipoprotein(a) characterization. Arteriosclerosis, Thrombosis, and Vascular Biology (2016) 36: 2019-2027. Abstract