Ito - Figure 10 - Candidates for apheresis
This Figure lists the criteria for LDL apheresis. If a patient does not have an adequate
response after 6 months of optimized, maximum-tolerated drug therapy, then that patient
should be referred for an LDL apheresis procedure. The criteria for this include
- patients who are considered to have functional homozygous FH;
- patients with LDL cholesterol levels >300 mg/dL or non-HDL cholesterol ≥330
mg/dL
and these patients should be referred for LDL apheresis. Functional heterozygous FH
patients who have at least 1 additional CVD risk factor are candidates for LDL apheresis
if they have LDL cholesterol levels ≥300 mg/dL or non-HDL cholesterols ≥330 mg/dL.
In addition, functional heterozygous FH patients who have
- ≥2 additional CHD risk factors
- an LP(a) level ≥50 mg/dL
- a serum LDL cholesterol level >200 mg/dL (or a non-HDL cholesterol >230 mg/
dL); that does not adequately respond to optimized drug therapy
should be referred for LDL apheresis. Finally, for the highest-risk, functional
heterozygous FH patients -- ie, those patients who have
- established CHD or other atherosclerotic disease
- diabetes with LDL cholesterol ≥160 mg/dL
- non-HDL cholesterol ≥190 mg/dL
these patients, again, should be referred for LDL apheresis.
Ito MK.
J Clin Lipidol.
2011; 5(6).
