title: The influence of smoking and lipids on restenosis after carotid endarterectomy.
abstract: Factors associated with restenosis were investigated in 107 patients undergoing carotid endarterectomy for symptomatic disease. The patients, 71 men and 36 women with mean age 68 +/- 8 years, were followed up for 1 year by serial Duplex scanning. Carotid restenosis of > or = 50% developed in 18 patients (17%), 11 men and seven women. Restenosis was not influenced by age, sex, diabetes or hypertension. Continuing smokers, serum cotinine > 200 nmol/l, had a significantly higher incidence of > or = 50% restenosis after 1 year (39%), compared with only 16% of non-smokers, p = 0.023. Restenosis > or = 50% also was associated significantly with below median body mass index (p = 0.027). Women undergoing carotid endarterectomy had higher levels of cholesterol (median 7.4 mmol/l) and apolipoprotein B (median 0.81 g/l) than men (median cholesterol 6.4 mmol/l, median apolipoprotein B 0.69 g/l), p < 0.01. For men only, restenosis of > or = 50% was associated with low levels of serum cholesterol (median 5.7 mmol/l), p = 0.002. For women cholesterol levels were higher (median 8.1 mmol/l) in those with > or = 50% restenosis. Smoking adversely influences early restenosis (1 year) after carotid endarterectomy. Hyperlipidaemia is not a risk factor for restenosis in men, but may be associated with restenosis in women.
authors.affiliation: Department of Surgery, Charing Cross and Westminster Medical School, London, U.K.
authors.forename: R
authors.initials: R
authors.lastname: Cuming
authors.forename: P
authors.initials: P
authors.lastname: Worrell
authors.forename: N E
authors.initials: NE
authors.lastname: Woolcock
authors.forename: P J
authors.initials: PJ
authors.lastname: Franks
authors.forename: R M
authors.initials: RM
authors.lastname: Greenhalgh
authors.forename: J T
authors.initials: JT
authors.lastname: Powell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001055:Apolipoproteins B / Q000032:analysis; D001157:Arterial Occlusive Diseases / Q000097:blood / Q000601:surgery*; D002340:Carotid Artery Diseases / Q000097:blood / Q000601:surgery*; D002343:Carotid Artery, Internal; D002784:Cholesterol / Q000097:blood; D003367:Cotinine / Q000097:blood; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012907:Smoking / Q000009:adverse effects*; D014280:Triglycerides / Q000097:blood
chemical_list: D001055:Apolipoproteins B; D008055:Lipids; D014280:Triglycerides; D002784:Cholesterol; D003367:Cotinine