Gordon et al listed conditions for which apheresis to remove low-density lipoproteins is indicated. This procedure can help reduce the risk of coronary artery disease. The authors are from New York Hospital-Cornell Medical Center in New York City, Christ Hospital in Cincinnati, Baylor College of Medicine in Houston and Oregon Health Sciences University in Portland.


Patients who may benefit from apheresis to remove low-density lipoproteins - one or more of the following::

(1) LDL cholesterol > 190 mg/dL AND coronary artery disease AND maximal medical management

(2) asymptomatic for coronary artery disease AND LDL cholesterol > 250 mg/dL AND first degree relative with premature coronary artery disease AND >= 1 additional risk factors AND age > 30 years if male or > 40 if female

(3) homozygous familial hypercholesterolemia AND poor response to medical management AND age > 5 years of age



• Additional risk factors are hypertension, diabetes mellitus, cigarette smoking and a low HDL cholesterol.

• Medical management includes a restrictive diet and lipid lowering drug therapy.

• Premature coronary heart disease is coronary artery disease in a male < 55 years of age or a female < 65 years of age.


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