德国脂蛋白分离登记处--第十一次年度报告摘要

IF 4.9 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Atherosclerosis Pub Date : 2024-09-19 DOI:10.1016/j.atherosclerosis.2024.118601
V.J.J. Schettler , N. Selke , S. Jenke , T. Zimmermann , G. Schlieper , W. Bernhardt , F. Heigl , P. Grützmacher , I. Löhlein , R. Klingel , B. Hohenstein , W. Ramlow , A. Vogt , U. Julius , Scientific Board of GLAR for the German Apheresis Working Group
{"title":"德国脂蛋白分离登记处--第十一次年度报告摘要","authors":"V.J.J. Schettler ,&nbsp;N. Selke ,&nbsp;S. Jenke ,&nbsp;T. Zimmermann ,&nbsp;G. Schlieper ,&nbsp;W. Bernhardt ,&nbsp;F. Heigl ,&nbsp;P. Grützmacher ,&nbsp;I. Löhlein ,&nbsp;R. Klingel ,&nbsp;B. Hohenstein ,&nbsp;W. Ramlow ,&nbsp;A. Vogt ,&nbsp;U. Julius ,&nbsp;Scientific Board of GLAR for the German Apheresis Working Group","doi":"10.1016/j.atherosclerosis.2024.118601","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>In 2012, the German Lipoprotein Apheresis Registry (GLAR) was launched. Real-world data on lipoprotein apheresis (LA) treatment are now available for a time period of 11 years. All patients received the maximally tolerated lipid-lowering therapy, which included statins, ezetimibe, bempedoic acid, and either proprotein convertase subtilisin/kexin type 9 (PCSK9) antibodies or antisense therapy.</div></div><div><h3>Methods and Results</h3><div>During the time period from 2012 to 2022, 92 German apheresis centers collected retrospective and prospective observational data of a total of 2,301 patients undergoing regular lipoprotein apheresis (LA) treatment of hypercholesterolemia or/and Lp(a)-hyperlipoproteinemia suffering from progressive atherosclerotic cardiovascular disease (ASCVD), with complete data sets of 1.125 patients, who were the subject of this analysis. More than 61,500 LA sessions are documented in the database. In 2022, all patients treated with LA demonstrated a significant immediate median reduction rate of LDL-C (68.8 %) and Lp(a) (72.9 %). Patient data were analyzed for the incidence rate of major coronary events (MACE) 1 and 2 years before the beginning of LA treatment (y-2 and y-1) and prospectively up to eleven years on LA treatment (y+1 to y+11). During the first two years of LA treatment (y+1 and y+2), a MACE reduction of 73 % was observed and continued to be low during y+3 to y+11, when all LA patients were analyzed. LA patients with only increased Lp(a) levels (Lp(a) ≥ 60 mg/dl (≥120 nmol/l) and an LDL-C &lt; 100 mg/dl (&lt;2.6 mmol/l)) had a higher MACE reduction (85 %; n = 443) in the first two years of LA treatment compared to LA patients with only increased LDL-C-levels (LDL-C ≥ 100 mg/dl (≥2.6 mmol/l); Lp(a) &lt; 60 mg/dl (&lt;120 nmol/l)) (53 %; n = 171). Adverse events of LA remained low (about 5 %) over the eleven years and mainly represented puncture problems (1.0 %). No side effects resulted in termination of LA therapy.</div></div><div><h3>Conclusions</h3><div>The current analysis of GLAR data indicates that regular LA leads to very low incidence rates of cardiovascular events in patients with high LDL-C and/or high Lp(a) levels, progressive ASCVD, and maximally tolerated lipid-lowering medication, including proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibition. Additionally, LA was safe with a low rate of adverse effects over an 11-year period. The number of enrolled patients and the duration of observation establish GLAR as the largest LA registry worldwide.</div></div>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":"398 ","pages":"Article 118601"},"PeriodicalIF":4.9000,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The German Lipoprotein Apheresis Registry-Summary of the eleventh annual report\",\"authors\":\"V.J.J. Schettler ,&nbsp;N. Selke ,&nbsp;S. Jenke ,&nbsp;T. Zimmermann ,&nbsp;G. Schlieper ,&nbsp;W. Bernhardt ,&nbsp;F. Heigl ,&nbsp;P. Grützmacher ,&nbsp;I. Löhlein ,&nbsp;R. Klingel ,&nbsp;B. Hohenstein ,&nbsp;W. Ramlow ,&nbsp;A. Vogt ,&nbsp;U. Julius ,&nbsp;Scientific Board of GLAR for the German Apheresis Working Group\",\"doi\":\"10.1016/j.atherosclerosis.2024.118601\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>In 2012, the German Lipoprotein Apheresis Registry (GLAR) was launched. Real-world data on lipoprotein apheresis (LA) treatment are now available for a time period of 11 years. All patients received the maximally tolerated lipid-lowering therapy, which included statins, ezetimibe, bempedoic acid, and either proprotein convertase subtilisin/kexin type 9 (PCSK9) antibodies or antisense therapy.</div></div><div><h3>Methods and Results</h3><div>During the time period from 2012 to 2022, 92 German apheresis centers collected retrospective and prospective observational data of a total of 2,301 patients undergoing regular lipoprotein apheresis (LA) treatment of hypercholesterolemia or/and Lp(a)-hyperlipoproteinemia suffering from progressive atherosclerotic cardiovascular disease (ASCVD), with complete data sets of 1.125 patients, who were the subject of this analysis. More than 61,500 LA sessions are documented in the database. In 2022, all patients treated with LA demonstrated a significant immediate median reduction rate of LDL-C (68.8 %) and Lp(a) (72.9 %). Patient data were analyzed for the incidence rate of major coronary events (MACE) 1 and 2 years before the beginning of LA treatment (y-2 and y-1) and prospectively up to eleven years on LA treatment (y+1 to y+11). During the first two years of LA treatment (y+1 and y+2), a MACE reduction of 73 % was observed and continued to be low during y+3 to y+11, when all LA patients were analyzed. LA patients with only increased Lp(a) levels (Lp(a) ≥ 60 mg/dl (≥120 nmol/l) and an LDL-C &lt; 100 mg/dl (&lt;2.6 mmol/l)) had a higher MACE reduction (85 %; n = 443) in the first two years of LA treatment compared to LA patients with only increased LDL-C-levels (LDL-C ≥ 100 mg/dl (≥2.6 mmol/l); Lp(a) &lt; 60 mg/dl (&lt;120 nmol/l)) (53 %; n = 171). Adverse events of LA remained low (about 5 %) over the eleven years and mainly represented puncture problems (1.0 %). No side effects resulted in termination of LA therapy.</div></div><div><h3>Conclusions</h3><div>The current analysis of GLAR data indicates that regular LA leads to very low incidence rates of cardiovascular events in patients with high LDL-C and/or high Lp(a) levels, progressive ASCVD, and maximally tolerated lipid-lowering medication, including proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibition. Additionally, LA was safe with a low rate of adverse effects over an 11-year period. The number of enrolled patients and the duration of observation establish GLAR as the largest LA registry worldwide.</div></div>\",\"PeriodicalId\":8623,\"journal\":{\"name\":\"Atherosclerosis\",\"volume\":\"398 \",\"pages\":\"Article 118601\"},\"PeriodicalIF\":4.9000,\"publicationDate\":\"2024-09-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Atherosclerosis\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0021915024011730\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Atherosclerosis","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0021915024011730","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0

摘要

背景2012年,德国脂蛋白分离注册中心(GLAR)成立。目前已有11年来的脂蛋白分离(LA)治疗的真实数据。所有患者都接受了最大耐受性降脂治疗,包括他汀类药物、依折麦布、贝美多酸和9型丙蛋白转换酶亚基酶/kexin(PCSK9)抗体或反义疗法。方法和结果在2012年至2022年期间,德国的92个无细胞疗法中心共收集了2301名接受常规脂蛋白无细胞疗法(LA)治疗的高胆固醇血症或/和Lp(a)-高脂蛋白血症的进展性动脉粥样硬化性心血管疾病(ASCVD)患者的回顾性和前瞻性观察数据,其中有1125名患者的完整数据集是本次分析的对象。数据库中记录了 61,500 多次 LA 治疗。2022 年,所有接受 LA 治疗的患者的低密度脂蛋白胆固醇(LDL-C)(68.8%)和脂蛋白(a)(72.9%)的即时中位数下降率都非常显著。对患者数据进行了分析,以了解LA治疗开始前1年和2年(y-2和y-1)以及LA治疗11年(y+1至y+11)的主要冠状动脉事件(MACE)发生率。在 LA 治疗的前两年(y+1 和 y+2),观察到 MACE 减少了 73%,在 y+3 至 y+11 期间,对所有 LA 患者进行分析时,MACE 减少率仍然很低。仅 Lp(a) 水平升高(Lp(a) ≥ 60 mg/dl (≥120 nmol/l)和 LDL-C < 100 mg/dl (< 2.6毫摩尔/升))的LA患者相比,LDL-C水平仅升高(LDL-C ≥ 100 mg/dl (≥2.6 mmol/l);Lp(a) < 60 mg/dl (<120 nmol/l))的LA患者在LA治疗的头两年中MACE减少率更高(85%;n = 443)(53%;n = 171)。十一年来,LA 的不良反应仍然很少(约 5%),主要是穿刺问题(1.0%)。结论目前对 GLAR 数据的分析表明,对于低密度脂蛋白胆固醇(LDL-C)和/或脂蛋白(a)水平较高、有进行性 ASCVD 和最大耐受性降脂药物(包括 9 型丙蛋白转换酶亚基酶/kexin (PCSK9) 抑制剂)的患者,定期服用 LA 可降低心血管事件的发生率。此外,在长达11年的时间里,LA安全性高,不良反应发生率低。GLAR登记的患者人数和观察时间使其成为全球最大的LA登记机构。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

摘要图片

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
The German Lipoprotein Apheresis Registry-Summary of the eleventh annual report

Background

In 2012, the German Lipoprotein Apheresis Registry (GLAR) was launched. Real-world data on lipoprotein apheresis (LA) treatment are now available for a time period of 11 years. All patients received the maximally tolerated lipid-lowering therapy, which included statins, ezetimibe, bempedoic acid, and either proprotein convertase subtilisin/kexin type 9 (PCSK9) antibodies or antisense therapy.

Methods and Results

During the time period from 2012 to 2022, 92 German apheresis centers collected retrospective and prospective observational data of a total of 2,301 patients undergoing regular lipoprotein apheresis (LA) treatment of hypercholesterolemia or/and Lp(a)-hyperlipoproteinemia suffering from progressive atherosclerotic cardiovascular disease (ASCVD), with complete data sets of 1.125 patients, who were the subject of this analysis. More than 61,500 LA sessions are documented in the database. In 2022, all patients treated with LA demonstrated a significant immediate median reduction rate of LDL-C (68.8 %) and Lp(a) (72.9 %). Patient data were analyzed for the incidence rate of major coronary events (MACE) 1 and 2 years before the beginning of LA treatment (y-2 and y-1) and prospectively up to eleven years on LA treatment (y+1 to y+11). During the first two years of LA treatment (y+1 and y+2), a MACE reduction of 73 % was observed and continued to be low during y+3 to y+11, when all LA patients were analyzed. LA patients with only increased Lp(a) levels (Lp(a) ≥ 60 mg/dl (≥120 nmol/l) and an LDL-C < 100 mg/dl (<2.6 mmol/l)) had a higher MACE reduction (85 %; n = 443) in the first two years of LA treatment compared to LA patients with only increased LDL-C-levels (LDL-C ≥ 100 mg/dl (≥2.6 mmol/l); Lp(a) < 60 mg/dl (<120 nmol/l)) (53 %; n = 171). Adverse events of LA remained low (about 5 %) over the eleven years and mainly represented puncture problems (1.0 %). No side effects resulted in termination of LA therapy.

Conclusions

The current analysis of GLAR data indicates that regular LA leads to very low incidence rates of cardiovascular events in patients with high LDL-C and/or high Lp(a) levels, progressive ASCVD, and maximally tolerated lipid-lowering medication, including proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibition. Additionally, LA was safe with a low rate of adverse effects over an 11-year period. The number of enrolled patients and the duration of observation establish GLAR as the largest LA registry worldwide.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Atherosclerosis
Atherosclerosis 医学-外周血管病
CiteScore
9.80
自引率
3.80%
发文量
1269
审稿时长
36 days
期刊介绍: Atherosclerosis has an open access mirror journal Atherosclerosis: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. Atherosclerosis brings together, from all sources, papers concerned with investigation on atherosclerosis, its risk factors and clinical manifestations. Atherosclerosis covers basic and translational, clinical and population research approaches to arterial and vascular biology and disease, as well as their risk factors including: disturbances of lipid and lipoprotein metabolism, diabetes and hypertension, thrombosis, and inflammation. The Editors are interested in original or review papers dealing with the pathogenesis, environmental, genetic and epigenetic basis, diagnosis or treatment of atherosclerosis and related diseases as well as their risk factors.
期刊最新文献
Statin-associated muscle symptoms: Not simply a genetic predisposition. Extracellular peroxiredoxin 5 exacerbates atherosclerosis via the TLR4/MyD88 pathway HDL and cardiovascular risk. Unveiling feature importance biases in linear regression: Implications for protein-centric cardiovascular research. Reply to: “Correspondence on: “Subclinical atherosclerosis: More data – More insights into prevention” ”
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1