Remnant-like lipoprotein particle level and insulin resistance are associated with in-stent restenosis in patients with stable angina.
BACKGROUND
The aim of this study was to evaluate the independent effect of serum remnant-like lipoprotein particle level and insulin resistance on in-stent restenosis in nondiabetic patients with stable angina.


METHODS
The study included 64 nondiabetic patients with stable angina who underwent successful coronary stenting. At the time of stenting, we evaluated the patients' lipid profiles including remnant-like lipoprotein particles cholesterol, plasma glucose and insulin levels, and insulin resistance by the homeostasis model assessment.


RESULTS
There was no significant difference in total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol levels between two patient groups with (n=15) and without (n=49) in-stent restenosis. Plasma remnant-like lipoprotein particles cholesterol level was significantly higher in patients with restenosis than in patients without restenosis (8.2+/-7.0 mg/dl vs. 4.5+/-2.6 mg/dl, P=0.006). Although plasma glucose level was similar between the two groups, insulin level and homeostasis model assessment were significantly higher in patients with restenosis, compared with those without restenosis (11.2+/-12.4 vs. 7.1+/-2.8, P=0.039; and 2.6+/-2.9 vs. 1.7+/-0.7, P=0.040, respectively). In multivariate logistic regression analysis, plasma remnant-like lipoprotein particles cholesterol level (>4.8 mg/dl; the 75th percentile of the distribution of remnant-like lipoprotein particles cholesterol level) was the independent predictor of in-stent restenosis (odds ratio: 8.15; confidence interval: 1.02-65.16; P=0.048).


CONCLUSIONS
Our findings suggest that high serum remnant-like lipoprotein particles cholesterol level, and not insulin resistance may be an independent risk factor on in-stent restenosis in nondiabetic patients with stable angina.
Kato
Toru
T
Department of Cardiovascular and Renal Medicine, Saga University Faculty of Medicine, Saga University, Saga, Japan. katotor@med.saga-u.ac.jp
Inoue
Teruo
T
Inagaki
Hiroshi
H
Hashimoto
Shigemasa
S
Hikichi
Yutaka
Y
Tanaka
Akira
A
Isobe
Mitsuaki
M
Node
Koichi
K
D000368:Aged; D000787:Angina Pectoris / Q000601:surgery*; D001786:Blood Glucose / Q000032:analysis; D002784:Cholesterol / Q000097:blood*; D023903:Coronary Restenosis / Q000209:etiology*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008074:Lipoproteins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D015607:Stents; D014280:Triglycerides / Q000097:blood*
D001786:Blood Glucose; D008074:Lipoproteins; D014280:Triglycerides; C112017:remnant-like particle cholesterol; D002784:Cholesterol