After 11 stents and a quadruple bypass, Chuck Firestine was told there was nothing else that could be done for his extremely high cholesterol. That was until Mercy began offering LDL apheresis, a procedure that dramatically reduces LDL cholesterol 73-83 percent after a single treatment.
Firestine has familial hypercholesterolemia, an under-recognized genetic condition that causes LDL ("bad") cholesterol levels to be very high. The condition begins at birth and can cause heart attacks at an early age.
He knew he had high cholesterol for years before his heart attack eight years ago. But that’s when he began trying all sorts of medications to lower his LDL, to no avail. Not only was the medication not working well enough, but it was making him sick – he’s also statin- intolerant.
“I tried all sorts of medication, but nothing worked and I couldn’t tolerate most of them,” Firestine said. “I knew there was a problem when they told me they couldn’t do any more stents and the bypass was closed off.”
The four arteries cleared during his quadruple bypass are already almost completely blocked again, one at 100 percent and the others at 98 and 95 percent blocked. Firestine was assessed for a heart transplant, but wasn’t a candidate. Losing hope, Firestine learned about the treatment newly offered at the Mercy Lipid Center in St. Louis – LDL apheresis.
LDL aphaeresis is similar to donating plasma; blood is withdrawn through a venous access, enters a plasma separator and passes through one of two LDL absorption columns. The columns are coated to selectively bind with plasma, removing the bad cholesterol and leaving HDL-c (good cholesterol) unaffected. The LDL-depleted plasma is then recombined with the blood cells and returned to the patient. The treatment takes two to three hours (depending on the patient) and is typically repeated every two weeks. During the procedure, patients enjoy a private room with a reclining chair, TV and DVD player.
“As fast as I build up cholesterol, it would have already closed off my arteries if this wasn’t available,” Firestine stated. “I would have had the heart attack I was expecting.”
LDL apheresis is for patients with high risk of atherosclerotic cardiovascular disease (ASCVD) along with very high LDL-c cholesterol that is either unresponsive to or insufficiently responsive to traditional lipid-lowering treatment, such as a more heart- healthy lifestyle and medications.
“For people who can do this treatment and take statins, it’s a wonderful combination,” said Krista Havlin, RN, ANP, FNP, clinical lipid specialist with Mercy Lipid Center. “For Chuck, he’s statin-intolerant, so this is literally his last option.”
After each treatment, labs are done and the numbers are compared. Firestine’s LDL drops by an average of 147 points after the apheresis treatments.
He recently quit his job to focus on his health and wants to make others with his condition aware there is something they can do.
“It’s the only thing that’s keeping me alive,” Firestine said. “If I had this 10-15 years ago, I probably wouldn’t be sitting here. If this would have been around sooner, it could have saved me all that [cholesterol buildup].