冠動脈疾患再発ハイリスク患者に対するLDLアフェレシスの適応(<特集>21世紀のアフェレシス-作用機序と臨床効果のエビデンス)

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The greatest significance of cholesterol-lowering therapy in hypercholesterolemic patients at high risk of coronary heart disease(CHD)recurrence is the prevention of acute coronary syndrome by stabilization of coronary atheromatous plaque. We often encounter patients in whom it is difficult to keep cholesterol at a desirable level with dietary therapy and medicinal treatment, in spite of the development and use of statins. In particular, many hypercholesterolemic patients with a family history of CHD exhibit drug resistance. For secondary prevention in patients with a high risk of the recurrence of CHD, whose cholesterol level cannot be controlled by drugs alone, LDL apheresis therapy, which involves LDL removal through extracorporeal circulation, is now available. Many reports concerning improvement of vascular endothelial function, improve- ment of myocardial ischemia, regression of coronary atherosclerotic lesions, stabilization of coronary plaque, and reduction incidence of cardiac events by LDL apheresis treatment have been made throughout the world. We believe that LDL apheresis should be used on hypercholesterolemic patients with existing CHD for whom diet and maximum cholesterol-lowering drug therapy has been ineffective or not tolerated and whose LDL cholesterol level is 160 mg/dl or more.
日本アフェレシス学会の論文
2001-02-28

著者

古賀伸彦
新古賀病院

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