Ito - Figure 10 - Candidates for apheresis Text

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).