P K Shah1, J Amin. 1. Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048.
Abstract
BACKGROUND: To determine the relation of post-percutaneous transluminal coronary angioplasty (PTCA) restenosis to serum lipid fractions and to circulating levels of endogenous tissue plasminogen activator (t-PA) and its rapid inhibitor (PAI-1), 68 patients with coronary artery disease who underwent a successful PTCA were studied. METHODS AND RESULTS: During a mean follow-up of 9 months (range, 7-11 months), 28 (41%) patients developed restenosis. A low high density lipoprotein (HDL) cholesterol level was independently and strongly related to both the risk of restenosis (p less than 0.001) and to the time of restenosis (p = 0.03). The mean HDL cholesterol level was 33 +/- 12 mg% in the restenosis group compared with 45 +/- 12 mg% in the nonrestenosis group (p less than 0.001). Restenosis developed in 22 of 34 (64%) patients with an HDL cholesterol less than or equal to 40 mg% compared with six of 34 (17%) patients with an HDL cholesterol greater than 40 mg% (p less than 0.002). The only other variable that was significantly related to restenosis was a low PAI-1 level (p = 0.04). CONCLUSIONS: The strong relation between a low HDL cholesterol level and the risk of restenosis suggests that lipid fractions could be important in the pathogenesis and prevention of restenosis.
BACKGROUND: To determine the relation of post-percutaneous transluminal coronary angioplasty (PTCA) restenosis to serum lipid fractions and to circulating levels of endogenous tissue plasminogen activator (t-PA) and its rapid inhibitor (PAI-1), 68 patients with coronary artery disease who underwent a successful PTCA were studied. METHODS AND RESULTS: During a mean follow-up of 9 months (range, 7-11 months), 28 (41%) patients developed restenosis. A low high density lipoprotein (HDL) cholesterol level was independently and strongly related to both the risk of restenosis (p less than 0.001) and to the time of restenosis (p = 0.03). The mean HDL cholesterol level was 33 +/- 12 mg% in the restenosis group compared with 45 +/- 12 mg% in the nonrestenosis group (p less than 0.001). Restenosis developed in 22 of 34 (64%) patients with an HDL cholesterol less than or equal to 40 mg% compared with six of 34 (17%) patients with an HDL cholesterol greater than 40 mg% (p less than 0.002). The only other variable that was significantly related to restenosis was a low PAI-1 level (p = 0.04). CONCLUSIONS: The strong relation between a low HDL cholesterol level and the risk of restenosis suggests that lipid fractions could be important in the pathogenesis and prevention of restenosis.
Authors: Dominic C Chow; James H Stein; Todd B Seto; Carol Mitchell; Narin Sriratanaviriyakul; Andrew Grandinetti; Mariana Gerschenson; Bruce Shiramizu; Scott Souza; Cecilia Shikuma Journal: AIDS Date: 2010-04-24 Impact factor: 4.177