Effects of increasing particle size of low-density lipoprotein on restenosis after coronary stent implantation.
BACKGROUND
Small dense low-density lipoprotein (LDL) has emerged as an important risk factor in coronary atherosclerosis and vascular inflammation, which is related to neointimal hyperplasia. Therefore, the aim of the present study was to investigate whether changes in LDL particle size are related to in-stent restenosis (ISR).


RESULTS
The LDL subfraction and lipid profiles were measured in 274 patients (412 stents) at both baseline and follow-up coronary angiography (CAG). The incidence of ISR (80 lesions, 19.4%) was lower in the patients with increased LDL particle size than in those with no change or decrease (14.2% vs 25.8%, p=0.004). Logistic multivariate analysis revealed that stent length (>or=24 mm) (odds ratio (OR) =1.913, p=0.027), post minimal luminal diameter (>3 mm) (OR =0.528, p=0.028), acute coronary syndrome (OR =2.294, p=0.005), decrease in high-density lipoprotein-cholesterol (OR =1.028, p=0.047) and increase in LDL particle size (OR =0.528, p=0.031) were independent predictors for ISR.


CONCLUSIONS
In the present study, an increase in the LDL particle size between baseline and follow-up CAG was associated with reduced incidence of ISR. Therefore, modification of LDL particle size may have a beneficial effect on the risk of ISR.
Kim
Jung-Sun
JS
Division of Cardiology, Yonsei University College of Medicine, Seoul, Korea.
Kim
Myung-Hyun
MH
Lee
Byoung Kwon
BK
Rim
Se-Joong
SJ
Min
Pil-Ki
PK
Yoon
Se-Jung
SJ
Kim
Jeong-Ho
JH
Rhee
Ji-Hyuck
JH
Yoon
Young Won
YW
Hong
Bum Kee
BK
Kwon
Hyuck Moon
HM
Kim
Changsoo
C
D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000378:metabolism; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008077:Lipoproteins, LDL / Q000097:blood* / Q000737:chemistry; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010316:Particle Size; D011237:Predictive Value of Tests; D012307:Risk Factors; D015607:Stents
D008077:Lipoproteins, LDL