Low high density lipoprotein level is associated with increased restenosis rate after coronary angioplasty.
BACKGROUND
To determine the relation of post-percutaneous transluminal coronary angioplasty (PTCA) restenosis to serum lipid fractions and to circulating levels of endogenous tissue plasminogen activator (t-PA) and its rapid inhibitor (PAI-1), 68 patients with coronary artery disease who underwent a successful PTCA were studied.


RESULTS
During a mean follow-up of 9 months (range, 7-11 months), 28 (41%) patients developed restenosis. A low high density lipoprotein (HDL) cholesterol level was independently and strongly related to both the risk of restenosis (p less than 0.001) and to the time of restenosis (p = 0.03). The mean HDL cholesterol level was 33 +/- 12 mg% in the restenosis group compared with 45 +/- 12 mg% in the nonrestenosis group (p less than 0.001). Restenosis developed in 22 of 34 (64%) patients with an HDL cholesterol less than or equal to 40 mg% compared with six of 34 (17%) patients with an HDL cholesterol greater than 40 mg% (p less than 0.002). The only other variable that was significantly related to restenosis was a low PAI-1 level (p = 0.04).


CONCLUSIONS
The strong relation between a low HDL cholesterol level and the risk of restenosis suggests that lipid fractions could be important in the pathogenesis and prevention of restenosis.
Shah
P K
PK
Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048.
Amin
J
J
D015906:Angioplasty, Balloon, Coronary; D008076:Cholesterol, HDL / Q000097:blood*; D003327:Coronary Disease / Q000097:blood* / Q000453:epidemiology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015849:Plasminogen Inactivators / Q000097:blood; D016016:Proportional Hazards Models; D012008:Recurrence; D012307:Risk Factors; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000097:blood
D008076:Cholesterol, HDL; D015849:Plasminogen Inactivators; D010959:Tissue Plasminogen Activator