There is one clinical trial.
The goal of this study is to determine the impact of apheresis on clinical parameters and symptoms of patients with refractory angina and raised Lp(a). The investigators will conduct a prospective, randomised controlled crossover study of 20 patients with refractory angina and raised Lp(a), randomised to undergoing lipoprotein apheresis weekly for three months or sham apheresis weekly for three months with assessment of myocardial perfusion, carotid atherosclerosis, endothelial vascular function, thrombogenesis, exercise capacity, angina symptoms and quality of life at the beginning and end of treatment. Patients will then crossover to the opposite study arm with the protocol repeated. The hypothesis is that the above parameters will be improved by lipoprotein apheresis in patients with raised Lp(a) and Refractory Angina. Investigators will also test for the genotypic presence of apolipoprotein(a) gene (LPA) locus variants (rs10455872 and rs3798220) which are thought to be associated with an increased level of Lp(a) and an increased risk of coronary disease.
Investigators will also test for the genotypic presence of apolipoprotein(a) gene (LPA) locus variants (rs10455872 and rs3798220) which are thought to be associated with an increased level of Lp(a) and an increased risk of coronary disease.
Description: Baseline compare to 3 month, changes presented Determine the impact of lipoprotein apheresis on quantitative myocardial perfusion measured by stress/rest cardiovascular magnetic resonance imaging. Increase means better outcome
Measure: Changes in Quantitative Myocardial Perfusion Measured by Stress/Rest Cardiovascular Magnetic Resonance Imaging Time: 3 monthsDescription: Changes from baseline to 3 months
Measure: Change in Carotid Atherosclerosis/Plaque Burden Determined by Cardiovascular Magnetic Resonance Imaging Time: 3 monthsDescription: EndoPat LnRHI - natural logarithm of reactive hyperaemia index. Increase - better outcome
Measure: Change in Endothelial Vascular Function Time: Within 7 days before and after 3 months of weekly lipoprotein apheresisDescription: SAQ—Angina stability, increase means improvement. 0-100 scale, Higher score means improvements
Measure: Change in Seattle Angina Questionnaire Score Time: 3 monthsDescription: Quality of Life score following, 0-100 score, high score improve quality of life
Measure: Change in SF-36 Quality of Life Score Time: 3 monthsDescription: Six minute walk test, patient can walk longer distance means improvements
Measure: Change in Exercise Capacity Determined by Six Minute Walk Test Time: 3 monthsDescription: Thrombogenesis, Reduce value is better to the patients
Measure: Changes in Markers of Thrombogenesis Time: 3 months