IU School of Medicine program lowers bad cholesterol

With over four years in the making, the IU School of Medicine now offers a new, preventative procedure to fight the onset of heart disease and heart attacks by targeting high cholesterol levels. \nThe IU Vascular Health Program is the first clinic in Indiana to offer the procedure, which helps patients lower the level of bad cholesterol, or low-density lipoprotein, in their blood through a two-hour process called LDL apheresis. According to the American Heart Association, 42 million American adults suffer from high cholesterol.\nThe main goal of the LDL apheresis procedure is to filter out extra amounts of bad cholesterol, while still allowing the blood to retain the good cholesterol, or high-density lipoprotein. Similarly, the procedure attempts to bring the levels back to the suggested goal of 100 milligrams per deciliter. \nWhen LDL levels reach above 100 mg/dL, there is an increased risk for heart disease or heart attacks, said Dr. Mark Deeg, director and founder of the IU Vascular Health Program.\nThis procedure is used in extreme cases to prevent or stop the onset of heart disease. The IU Vascular Health Program screens all potential patients and, using Federal Drug Administration guidelines, advises them as to whether they need the treatment.\nAccording to program officials, many of the patients who will qualify for this procedure have tried lipid-lowering medications first and have been unresponsive to them. \nThe procedure is specifically designed for three types of patients: those diagnosed with heart disease whose LDL levels exceed 200 mg/dL, those not diagnosed with heart disease, but whose LDL levels are above 300 mg/dL, and those proven to be genetically predisposed to extremely high LDL levels.\nThe new procedure, which takes about two hours to complete, filters out the LDL or "selectively removes the bad stuff," Deeg explained. Patients can sometimes show results in a matter of hours.\n"In an hour, we can drop cholesterol levels by 60 or 70 percent," he said. \nThough the procedure is relatively quick, patients must come back every two weeks for the rest of their lives in order for it to be effective. \nThe only risk involved in the procedure is the two intravenous lines hooked into the arms of the patients, said Dr. Sue Kirkman, also of the IU Vascular Health Program.\n"Some patients complain of dizziness while on the machine, but there are really no major risks," she said.\nProgram officials said the procedure has other positive effects beyond lowering the patient's LDL levels. The LDL apheresis procedure can also help correct acute hearing loss in patients. Acute hearing loss is caused by low blood flow through the inner ear. However, by lowering the LDL in the blood stream, the blood flow in the ear increases, thus allowing the patient to gain their hearing back. Deeg hopes that soon the IU School of Medicine will be able to offer the apheresis procedure specifically for acute hearing loss. \nOriginally developed and performed in Germany and Japan, the LDL apheresis has only slowly been acclimated into the U.S. health care system. This is largely because the procedure costs upwards of $50,000 to $60,000 and requires preapproval from the patients' insurance companies. In many cases, Deeg said he must speak personally with the insurance companies and make a strong case for his patients.\nDr. Deeg has been working with lipids for about 10 years, but only recently was able to implement the program through the School of Medicine. \n"It took four years to get through all the paperwork," Deeg said. \nThough the process is not necessarily in high demand, Deeg said he decided Indiana's only medical school needed to offer the procedure because there are enough patients who would benefit from it.\nHe had only a couple of patients who needed the treatments, but felt it was necessary because "they had no other choice left."\n"It was the right thing to do for my patients," he said.\nWithout anywhere to go in Indiana, the nearest clinic for patients to get the treatment was in Cincinnati. Kirkman said patients that needed such a procedure did not want to drive to Ohio to obtain treatment. Deeg and Kirkman themselves had to travel to the University of Kansas and its school of medicine to gain information on the treatments. \nAlthough this is a relatively new procedure in Indiana -- the clinic's first patient began treatment in April -- it is a major stepping stone for the IU Vascular Health Program and the IU School of Medicine. Now patients who cannot take lipid lowering medications or who have a genetic disorder in relation to their cholesterol can seek treatment and hopefully stop the possibility of heart disease or heart attacks. \nFor more information, contact Ostella Honeycutt at (317) 274-4347 or www.bbraunusa.com.\n-- Contact staff writer Erin Revtyak at erevtyak@indiana.edu.