Single Low-Density Lipoprotein Apheresis Does Not Improve Vascular Endothelial Function in Chronically Treated Hypercholesterolemic Patients

Abstract EN

Objective.

To investigate vascular endothelial function (VEF) responses to a single low-density lipoprotein (LDL) apheresis session in hypercholesterolemic patients undergoing chronic treatment.

Methods.

We measured brachial artery flow-mediated dilation (FMD), plasma lipids, vitamin E (α- and γ-tocopherol), markers of oxidative/nitrative stress (malondialdehyde (MDA) and nitro-γ-tocopherol (NGT)), and regulators of NO metabolism (arginine (ARG) and asymmetric dimethylarginine (ADMA)) prior to (Pre) and immediately following (Post) LDL apheresis and at 1, 3, 7, and 14 d Post in 5 hypercholesterolemic patients ( 52 ± 11 y).

Results.

Relative to Pre, total cholesterol ( 7.8 ± 1.5 mmol/L) and LDL-cholesterol ( 6.2 ± 1.2 mmol/L) were 61% and 70% lower ( P < 0.01 ), respectively, at Post and returned to Pre levels at 14 d.

Brachial FMD responses ( 6.9 ± 3.6 %) and plasma MDA, ARG, and ADMA concentrations were unaffected by LDL apheresis.

Plasma α-tocopherol, γ-tocopherol, and NGT concentrations were 52–69% lower at Post ( P < 0.01 ), and α-tocopherol remained 36% lower at 1 d whereas NGT remained 41% lower at d 3.

Conclusions.

Acute cholesterol reduction by LDL apheresis does not alter VEF, oxidative stress, or NO homeostasis in patients treated chronically for hypercholesterolemia.