Relationship between preheparin lipoprotein lipase mass concentration in serum and bare metal stent restenosis.
OBJECTIVE
Insulin resistance or inflammation is known to be related with lipoprotein lipase activity and these factors are also closely associated with the pathogenesis of bare-metal stent restenosis. This study examined the relationship between preheparin lipoprotein lipase protein (preheparin LpL mass) concentration in serum and bare-metal stent restenosis.


METHODS
A total of 121 lesions in 112 patients who underwent bare-metal stent implantation using NIR stent or S660/670 stent were examined. Subjects were divided into two groups (N group; patients with normal preheparin LpL mass concentration, n = 50 or L group; patients with low preheparin LpL mass concentration, n = 71) according to the mean levels of preheparin LpL mass concentration (male 39.3 ng/ml, female 50.6 ng/ml).


RESULTS
There were no differences in percutaneous coronary intervention or angiographical characteristics. The L group had a significantly higher incidence of restenosis rate and target lesion revascularization than the N group (N group vs L group: 8.0% vs 42.3%, p < 0.0001; 8.0% vs 33.8%, p = 0.0008, respectively). Homeostatic model assessment of insulin resistance as a marker of insulin resistance and high sensitive C-reactive protein concentration were significantly higher in the L group than the N group. Multiple regression analysis showed that only low preheparin LpL mass concentration was an independent factor for restenosis (t value = 3.6, p = 0.0005).


CONCLUSIONS
Preheparin LpL mass concentration is closely associated with bare-metal stent restenosis and preheparin LpL mass concentration may be an important marker for the selection of bare-metal stent or drug-eluting stent.
Hitsumoto
Takashi
T
Division of Internal Medicine, Sakura Hospital, Toho University School of Medicine, Chiba. thitsu@jcom.home.ne.jp
Takahashi
Mao
M
Iizuka
Takuo
T
Shirai
Kohji
K
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000201:enzymology / Q000628:therapy; D023903:Coronary Restenosis / Q000097:blood* / Q000201:enzymology; D005260:Female; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D007333:Insulin Resistance; D008071:Lipoprotein Lipase / Q000378:metabolism*; D008297:Male; D008670:Metals; D008875:Middle Aged; D011956:Receptors, Cell Surface / Q000097:blood*; D012044:Regression Analysis; D012307:Risk Factors; D015607:Stents
D015415:Biomarkers; C484074:LPL binding proteins, human; D008670:Metals; D011956:Receptors, Cell Surface; D006493:Heparin; D002097:C-Reactive Protein; D008071:Lipoprotein Lipase