title: Prevention of restenosis after percutaneous transluminal coronary angioplasty by reducing lipoprotein (a) levels with low-density lipoprotein apheresis. Low-Density Lipoprotein Apheresis Angioplasty Restenosis Trial (L-ART) Group.
abstract: This study was designed to test the hypothesis that high plasma lipoprotein (a) (Lp[a]) levels are associated with an increase incidence of restenosis after angioplasty. Elective transluminal coronary angioplasty was performed in 66 patients (58 men and 8 women) aged 57 +/- 9 years (mean +/- SD). Two days before and 5 days after angioplasty, all patients underwent low-density lipoprotein (LDL) apheresis with a dextran sulfate cellulose column as an Lp(a) absorbent; 39 patients also received 10 mg of pravastatin and 1,500 mg of niacin daily. Restenosis was defined as a recurrent luminal stenosis of > or = 50% in a previously dilated segment. Median Lp(a) levels were reduced from 23.3 mg/dl before apheresis to 10.9 mg/dl after apheresis (p < 0.0001). Angiography performed 2 to 9 months after angioplasty revealed restenosis in at least 1 site in 38% of the 137 control patients and in 32% of the 66 patients who underwent apheresis. Restenosis also occurred in 37% of the patients who underwent apheresis alone and in 28% of the patients who also received pravastatin and niacin in combination with LDL apheresis. The restenosis rate was 21% in the 42 patients whose Lp(a) levels were significantly reduced > or = 50%, and in 50% of the 24 patients whose Lp(a) levels were significantly reduced < 50% (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Internal Medicine, Juntendo University, Juntendo Urayasu Hospital, Tokyo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Daida
authors.forename: Y J
authors.initials: YJ
authors.lastname: Lee
authors.forename: H
authors.initials: H
authors.lastname: Yokoi
authors.forename: T
authors.initials: T
authors.lastname: Kanoh
authors.forename: S
authors.initials: S
authors.lastname: Ishiwata
authors.forename: K
authors.initials: K
authors.lastname: Kato
authors.forename: H
authors.initials: H
authors.lastname: Nishikawa
authors.forename: F
authors.initials: F
authors.lastname: Takatsu
authors.forename: H
authors.initials: H
authors.lastname: Kato
authors.forename: Y
authors.initials: Y
authors.lastname: Kutsumi
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001781:Blood Component Removal; D002784:Cholesterol / Q000097:blood; D017023:Coronary Angiography; D003327:Coronary Disease / Q000097:blood* / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D014280:Triglycerides / Q000097:blood
chemical_list: D017270:Lipoprotein(a); D014280:Triglycerides; D002784:Cholesterol