Long-term clinical experience with HELP-LDL-apheresis in combination with HMG-CoA-reductase inhibitors for maximum treatment of coronary heart disease associated with severe hypercholesterolemia.

Extracorporeal low density lipoprotein (LDL)-apheresis offers an adjunctive therapy to diet and drug treatment for reducing LDL concentrations in patients with excessively high cholesterol levels and those at high coronary risk. After nearly 4 years experience with the heparin-induced extracorporeal LDL/fibrinogen precipitation (HELP) system, based on heparin induced LDL precipitation at acidic pH, over 7,000 single aphereses have been performed on more than 100 patients in several clinics. Due to the simultaneous removal of LDL and fibrinogen, regular HELP-LDL-apheresis can normalize hemorrheologic parameters, thus explaining the observation of a rapid and lasting clinical improvement in signs and symptoms of coronary heart disease (CHD). The use of Simvastatin in combination with HELP significantly augments the reduction in LDL cholesterol to a level where regression of atherosclerotic lesions might be expected.