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A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Association between plasma lipoprotein(a) concentration and restenosis after stent implantation
Tadaaki Kamitani1, Takuya Taniguchi, Nobuyuki Miyai
1Department of Cardiology, Matsushita Memorial Hospital, kamitani.tadaaki@jp.panasonic.com
Insights
Elevated plasma lipoprotein (a) [Lp(a)] levels are linked to increased in-stent restenosis after coronary stent implantation. Higher Lp(a) concentration independently predicts this adverse outcome, highlighting its clinical significance.
Area of Science:
- Cardiology
- Vascular Biology
- Biochemistry
Background:
- Plasma lipoprotein (a) [Lp(a)] concentration is a known risk factor for atherosclerotic and thrombotic vascular diseases.
- In-stent restenosis is a significant complication following coronary stent implantation.
Purpose of the Study:
- To investigate the association between plasma Lp(a) concentration and the occurrence of in-stent restenosis.
- To determine if Lp(a) is an independent predictor of restenosis after coronary stenting.
Main Methods:
- Follow-up angiography was performed on 109 patients after elective coronary stent implantation.
- Plasma Lp(a) concentrations and other lipid profiles were measured.
- Univariate and multivariate regression analyses were used to assess predictors of restenosis.
Main Results:
- Restenosis occurred in 38 patients, with smaller reference diameter and longer lesion length observed in this group.
- Plasma Lp(a) concentrations were significantly higher in patients with restenosis compared to those without (30.5 vs. 16.9 mg/dl).
- A high Lp(a) group (> 40 mg/dl) showed a significantly higher restenosis rate (71.4%) and late loss.
Conclusions:
- Plasma Lp(a) concentration is an independent predictor of in-stent restenosis.
- These findings underscore the importance of monitoring Lp(a) levels in patients undergoing coronary stenting.
Background:
The plasma concentration of lipoprotein (a) [Lp(a)] is associated with atherosclerotic and thrombotic vascular diseases. The aim of the present study was to evaluate the association between plasma Lp(a) concentration and in-stent restenosis.
Methods And Results:
One hundred and 9 patients with successful elective coronary stent implantation underwent follow-up angiography at 24+/-6 weeks. Restenosis after stent implantation occurred in 38 patients. Univariate analysis showed that the reference diameter of the lesion was smaller in the restenosis group (2.93+/-0.29 mm) than in the no-restenosis group (3.21+/-0.43 mm) (p < 0.05). The lesion was longer in the restenosis group (14.2+/-5.3 mm) than in the no-restenosis group (11.6+/-4.9 mm) (p < 0.05). Plasma Lp(a) concentrations in the restenosis group (30.5+/-23.9 mg/dl) were higher than in the no-restenosis group (16.9+/-11.1 mg/dl) (p < 0.01). Other lipid concentrations were similar in both groups. Among the plasma Lp(a) concentrations, the rate of restenosis (71.4%) in the high Lp(a) group (> 40 mg/dl) (n = 14) was greater compared with the other groups: 33.3% in the intermediate Lp(a) group (10-40 mg/dl) (n = 54), and 24.4% in the low Lp(a) group (< 10 mg/dl) (n = 41) (p < 0.01). The late loss (0.57+/-0.53 mm) in the low Lp(a) group was significantly less than the other groups: 0.88+/-0.47 mm in the intermediate Lp(a) group, and 1.08+/-0.56 mm in the high Lp(a) group (p < 0.05). In a multivariate regression model, plasma Lp(a) concentration remained significant as an independent predictor of restenosis in patients undergoing stent implantation (p = 0.020 odds ratio (OR) 1.37 95%conficence interval (CI) 1.050-1.793), although the reference diameter (p = 0.025 OR 0.23 95%CI 0.061-0.830) and lesion length (p = 0.021 OR 1.12 95%CI 1.017-1.232) were related to stent restenosis.
Conclusions:
Plasma Lp(a) concentration is an independent predictor of stent restenosis.