Imperial College London
Alternate

ProfessorPeterCollins

Faculty of Medicine, National Heart & Lung Institute

Professor of Clinical Cardiology
 
 
 
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Contact

 

+44 (0)20 7351 8112peter.collins

 
 
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Location

 

Chelsea WingRoyal Brompton Campus

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Summary

 

Publications

Citation

BibTex format

@article{Khan:2017:eurheartj/ehx178,
author = {Khan, TZ and Hsu, LY and Arai, AE and Rhodes, S and Pottle, A and Wage, R and Banya, W and Gatehouse, PD and Giri, S and Collins, P and Pennell, DJ and Barbir, M},
doi = {eurheartj/ehx178},
journal = {European Heart Journal},
pages = {1561--1569},
title = {Apheresis as novel treatment for refractory angina with raised lipoprotein(a): a randomised controlled trial},
url = {http://dx.doi.org/10.1093/eurheartj/ehx178},
volume = {38},
year = {2017}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - AimsTo determine the clinical impact of lipoprotein apheresis in patients with refractory angina and raised lipoprotein(a) > 500 mg/L on the primary end point of quantitative myocardial perfusion, as well as secondary end points including atheroma burden, exercise capacity, symptoms, and quality of life.MethodsWe conducted a single-blinded randomized controlled trial in 20 patients with refractory angina and raised lipoprotein(a) > 500 mg/L, with 3 months of blinded weekly lipoprotein apheresis or sham, followed by crossover. The primary endpoint was change in quantitative myocardial perfusion reserve (MPR) assessed by cardiovascular magnetic resonance. Secondary endpoints included measures of atheroma burden, exercise capacity, symptoms and quality of life.ResultsThe primary endpoint, namely MPR, increased following apheresis (0.47; 95% CI 0.31–0.63) compared with sham (−0.16; 95% CI − 0.33–0.02) yielding a net treatment increase of 0.63 (95% CI 0.37–0.89; P < 0.001 between groups). Improvements with apheresis compared with sham also occurred in atherosclerotic burden as assessed by total carotid wall volume (P < 0.001), exercise capacity by the 6 min walk test (P = 0.001), 4 of 5 domains of the Seattle angina questionnaire (all P < 0.02) and quality of life physical component summary by the short form 36 survey (P = 0.001).ConclusionLipoprotein apheresis may represent an effective novel treatment for patients with refractory angina and raised lipoprotein(a) improving myocardial perfusion, atheroma burden, exercise capacity and symptoms.
AU  - Khan,TZ
AU  - Hsu,LY
AU  - Arai,AE
AU  - Rhodes,S
AU  - Pottle,A
AU  - Wage,R
AU  - Banya,W
AU  - Gatehouse,PD
AU  - Giri,S
AU  - Collins,P
AU  - Pennell,DJ
AU  - Barbir,M
DO  - eurheartj/ehx178
EP  - 1569
PY  - 2017///
SN  - 1522-9645
SP  - 1561
TI  - Apheresis as novel treatment for refractory angina with raised lipoprotein(a): a randomised controlled trial
T2  - European Heart Journal
UR  - http://dx.doi.org/10.1093/eurheartj/ehx178
UR  - http://hdl.handle.net/10044/1/45707
VL  - 38
ER  -
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