Effect of heparin-induced extracorporeal low-density lipoprotein precipitation and bezafibrate on hemorheology and clinical symptoms in cerebral multiinfarct disease.

The effects of heparin-mediated extracorporeal low-density lipoprotein (total cholesterol, lipoprotein (a), triglycerides, fibrinogen) precipitation (HELP) and bezafibrate on fibrinogen, metabolic parameters, hemorheological patterns and clinical symptoms were studied in 40 patients suffering from cerebral multiinfarct disease. After a single HELP application, the patients were randomly assigned to two groups, either receiving sustained-release bezafibrate 400 mg (n = 21) or placebo (n = 19) over a period of 8 weeks. In all cases, HELP led to a statistically significant reduction of fibrinogen (p < 0.0001) and other parameters relevant to hemorheology, this effect, however, only being retained in the bezafibrate group. Parallel to this development, the Mathew scale revealed an improvement after HELP (p < 0.01 in each group) with a further improvement in the bezafibrate group (p < 0.05). The Mini Mental State Examination also showed improved results after HELP (p < 0.0005 and p < 0.03, respectively), a further improvement being observed in the bezafibrate group (p < 0.05). Comparing the day after HELP treatment to that at the end of the study, the Activities of Daily Living Score showed a statistically significant difference in the fibrate group (p < 0.05). These results support the hypothesis that the improved hemorheologic property of blood is an important factor in clinical recovery as well as basic neurologic function.