Nutrition, Metabolism, and Cardiovascular Diseases · Oct 7, 2026

Cross-sectional study in a lipoprotein apheresis centre: a thirty-year history of Practice, Investigation and Struggle against Atherosclerotic disease (P.I.S.A.)

By Sbrana F, Bigazzi F, Ripoli A et al.

BACKGROUND AND AIM: Lipoprotein apheresis (LA) has a protective role for endothelium and microcirculation and is able to reduce the incidence of major cardiovascular events. Recent advances in lipid-lowering drug therapy (LLT) lead to an improvement in the pre-apheresis lipid profile. METHODS AND RESULTS: This cross-sectional study with retrospective event collection evaluates patient's clinical characteristic, backbone lipid-lowering therapies (LLT), major cardiovascular events (MACE) rate and causes of LA discontinuation in subjects who do not reach LDL-Cl (Group A - 36/92 patients), Lp(a) target values (Group B - 24/92 patients) or both (Group C - 32/92 patients). The prevalence of pre-LA and post-LA MACEs was respectively 203 and 75 events with a significant lower observed MACE rates in all the groups, the Kaplan-Meier analysis of time to first MACE during LA showed no difference in the three groups. Moreover, PCSK9i contribute to overcome statin intolerance allowing, especially in patients on group A, to discontinue LA. CONCLUSIONS: Currently, LA maintaining a therapeutic role in subjects who do not reach LDL-C and/or Lp(a) targets, have a history of multiple MACEs and/or polydistrict atherosclerotic vascular disease or pregnancy HoFH who transient discontinue LLT.

doi.org/10.1016/j.numecd.2026.105029PubMed 42951784Interventions