New Therapy for Extremely High Cholesterol

There's a new treatment for extremely high cholesterol levels that haven't responded optimally to treatment — and the Emory Heart & Vascular Center working in conjunction with the Plasmapheresis Center at Emory, is the first site in Georgia to offer it.

LDL-C apheresis, that can "wash" so-called bad cholesterol (low density lipoprotein or LDL) out of the plasma of individuals who are at high risk for atherosclerotic disease complications due to elevated cholesterol.

Peggy Vardeman of Gainesville is one of the first patients to benefit from the treatment. Like many other people with a genetic predisposition resulting in extremely high cholesterol levels (a condition called familial hypercholesterolemia), Vardeman developed heart disease. She suffered a heart attack in l990 and had five angioplasties to open blocked arteries and also underwent quadruple coronary artery bypass surgery.

Even though she followed her doctor's orders conscientiously — losing weight, exercising, eating a near vegetarian diet and taking a combination of statin drugs and other medications — she still continued to develop coronary artery blockages.

"Nothing would get my cholesterol below 300," recalls Vardeman, 70, who also continued to have angina that presented atypically as back and shoulder pain.

In fact, before Vardeman was treated at Emory with LDL-C apheresis, her total cholesterol was 423. Today, following the therapy, her total cholesterol levels are near normal and her LDL lipoprotein is down to 60 from a high of 253. "This procedure is saving my life," says Vardeman. "I no longer have the back pain or leg cramps at night. I feel great and I'm even doing step aerobics."

Laurence Sperling, MD, Director of the Heart Disease Prevention Clinic at Emory, points out that although adequate control of serum cholesterol levels is usually accomplished by dietary modifications and/or drug regimens, a subset of patients, particularly those with familial hypercholesterolemia like Vardeman, fail to respond optimally.

"Those people can have a high level of cholesterol that remains significantly elevated despite all other available treatments," notes Dr. Sperling. He explains that to be eligible for the LDL-C aphereris therapy, patients must have LDL levels over 200 mg/dl with known coronary artery or vascular disease despite optimal therapy, or LDL levels greater than 300 mg/dl, with significant risk factors.

"We believe LDL-C apheresis is an important addition to the therapies available to treat extreme hypercholesterolemia, especially those with genetic lipid problems," he says. "We have seen patients with cholesterol levels of 450 mg/dl or more despite medical therapies whose LDL levels were reduced to 50 mg/dl after treatment."

Using the LIPOSORBER® System, LDL-C aphereris acutely removes LDL-C from the plasma of high risk patients. The plasma is separated and pumped into LDL absorption columns where apolipoprotein B-containing lipoproteins are selectively absorbed by dextran sulfate cellulose beads within the column before being returned to the body. "There is minimal effect on other plasma components such as high-density lipoprotein (HDL), known as 'good/cholesterol, and albumin and the therapy appears to be well tolerated," Dr. Sperling says.

Although the procedure takes about two and a half hours and must be repeated every few weeks, Peggy Vardeman says it is not painful and she doesn't mind.

"I feel better physically and mentally. For the first time, I feel like I'm in control of my cholesterol level. I'm a very active person and I can now look forward to the future," she says. "In fact, my granddaughter, who is now seven, and I are planning on getting a convertible and traveling together when she is seventeen. I enjoy living and I still have a lot of living to do."

Know someone who might benefit from LDL-C aphereris? Call Emory HealthConnection℠ at 404-778-7777 to find out more.