Luminal loss and restenosis after coronary angioplasty. The role of lipoproteins and lipids.
OBJECTIVE
Lipoproteins and lipids, especially lipoprotein(a), have been studied as risk factors for restenosis after coronary angioplasty with conflicting results. We investigated the association between serum levels of lipoprotein(a) apolipoprotein A-1, apolipoprotein B-100, total-cholesterol, high density lipoprotein-cholesterol, triglycerides, and coronary luminal loss and restenosis after angioplasty.


METHODS
The lipoproteins and lipids were measured in 305 consecutive patients who underwent successful angioplasty and reangiography 20+/-3 weeks after angioplasty. Single-vessel dilatation was performed in 251 patients. Luminal loss was defined as minimal luminal diameter post-angioplasty minus minimal luminal diameter at follow-up, divided by the interpolated reference diameter of the vessel. Restenosis was defined according to three dichotomous categorical criteria: (1) >50% diameter stenosis at follow-up (2) loss of >50% of the gain achieved by angioplasty, (3) the need for target vessel revascularization.


RESULTS
There was no significant association between the serum levels of lipoproteins and lipids and luminal loss. Univariate analysis did not show any significant difference in the serum levels of any of the lipoproteins and lipids between the restenosis and no-restenosis groups. Multivariate analysis revealed that only the angiographic variables (luminal gain and post-angioplasty minimal luminal diameter) were associated with luminal loss and restenosis after angioplasty.


CONCLUSIONS
Lipoproteins and lipids were neither associated with luminal loss nor independent risk factors for restenosis after angioplasty.
Jorgensen
B
B
Department of Cardiology, Rikshospitalet, University of Oslo, Oslo, Norway.
Simonsen
S
S
Endresen
K
K
Forfang
K
K
Egeland
T
T
Høstmark
A T
AT
Thaulow
E
E
D017311:Amlodipine / Q000627:therapeutic use; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003327:Coronary Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood*; D017270:Lipoprotein(a) / Q000097:blood*; D008074:Lipoproteins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D014665:Vasodilator Agents / Q000627:therapeutic use
D008055:Lipids; D017270:Lipoprotein(a); D008074:Lipoproteins; D014665:Vasodilator Agents; D017311:Amlodipine