A patient with homozygous familial hypercholesterolemia who was receiving LDL apheresis suffered an acute myocardial infarction after PCSK9 inhibitor treatment was started

Takai Kanako, Yokota Atsushi

doi:10.4009/jsdt.52.545

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Other Title

PCSK9阻害薬の開始後急性心筋梗塞を発症したLDLアフェレーシス施行中の家族性高コレステロール血症ホモ接合体の1例
症例報告 PCSK9阻害薬の開始後急性心筋梗塞を発症したLDLアフェレーシス施行中の家族性高コレステロール血症ホモ接合体の1例
ショウレイホウコク PCSK9 ソガイヤクノカイシゴキュウセイシンキンコウソクオハッショウシタ LDL アフェレーシスシコウチュウノカゾクセイコウコレステロールケッショウホモセツゴウタイノ 1レイ

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Abstract

<p>A 66-year-old male patient was diagnosed with homozygous familial hypercholesterolemia (FH) 29 years ago and had been receiving low-density lipoprotein (LDL) apheresis twice a month. He underwent coronary artery bypass grafting for unstable angina pectoris. His serum LDL-cholesterol (LDL-C) level before LDL apheresis was 126 mg/dL while he was receiving atorvastatin and ezetimibe. As an FH patient with cardiovascular disease, his serum LDL-C level was a little high compared with the target level of 70 mg/dL. He started to receive a PCSK9 inhibitor in addition to the standard therapy to lower his LDL-C level, and the frequency of LDL apheresis was reduced from twice to once a month, because puncturing became difficult and imposed a large burden on the patient. The patient suffered a myocardial infarction five months after the PCSK9 inhibitor treatment was started, even though his serum LDL-C level had fallen (62.7 mg/dL before and 21.3 mg/dL after LDL apheresis). His cardiac function improved after a percutaneous coronary intervention targeting the right coronary artery.</p>

Journal

Nihon Toseki Igakkai Zasshi

Nihon Toseki Igakkai Zasshi 52 (9), 545-550, 2019

The Japanese Society for Dialysis Therapy

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