Lipoproteins and the development of restenosis after stent implantation in the superficial femoral artery in patients with peripheral artery disease.
OBJECTIVE
High levels of apolipoprotein B (apo B) are a risk factor for the development of major vascular events. We evaluated the association between plasma lipoproteins and the development of superficial femoral artery (SFA) in-stent restenosis and reocclusion in patients with peripheral artery disease.


METHODS
We included 139 patients with SFA stenting. Plasma lipoproteins were measured after stent implantation. Stent restenosis was assessed with duplex scan after 3, 6, and 12 months. A stenosis grade was considered relevant if >50%.


RESULTS
Seventy-two patients experienced recurrence of their atherosclerotic disease, meaning restenosis of >50% within 1 year of follow-up. Ten of these patients had a stent occlusion. In the patients who experienced recurrence, the mean apo B level was 105.8 versus 94.9 mg/dl in patients without recurrence (P < 0.05). Patients without recurrence had higher high-density lipoprotein cholesterol levels than patients with recurrence (39.7 vs. 34.7 mg/dl, P < 0.05). Comparing patients with a stent occlusion (n = 10) and those with a restenosis of 75-99% (n = 28), the patients with a stent occlusion had higher levels of plasma cholesterol (234.1 vs. 185.9 mg/dl, P < 0.05), apo B (135.3 vs. 99.8 mg/dl, P < 0.05), low-density lipoprotein cholesterol (160.3 vs. 113.6 mg/dl, P < 0.05), and low-density lipoprotein apo B (115.5 vs. 82.4 mg/dl, P < 0.001) than the patients with restenosis of 75-99% (n = 28).


CONCLUSIONS
Changes in the lipid profile could be one reason for the development of restenosis and for the development of reocclusion after SFA stenting.
Division of Angiology, Medical University of Graz, Auenbruggerplatz 15 8036, Graz, Austria. thomas.gary@medunigraz.at
Thomas
T
Gary
Peter
P
Rief
Tatjana
T
Stojakovic
Harald
H
Froehlich
Hubert
H
Scharnagl
Franz
F
Hafner
Ernst
E
Pilger
Marianne
M
Brodmann
D000368:Aged; D000369:Aged, 80 and over; D016632:Apolipoprotein A-I / Q000097:blood; D001055:Apolipoproteins B / Q000097:blood*; D001157:Arterial Occlusive Diseases / Q000097:blood* / Q000000981:diagnostic imaging / Q000628:therapy*; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D004868:Equipment Failure; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006801:Humans; D008074:Lipoproteins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D054318:No-Reflow Phenomenon / Q000097:blood*; D012008:Recurrence; D012307:Risk Factors; D015607:Stents; D014280:Triglycerides / Q000097:blood; D018616:Ultrasonography, Doppler, Duplex
D016632:Apolipoprotein A-I; D001055:Apolipoproteins B; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D008074:Lipoproteins; D014280:Triglycerides; D002784:Cholesterol