Association between plasma lipoprotein (a)‎ concentration and restenosis after stent implantation

Abstract EN

Background / Aim : the plasma concentration of lipoprotein (a) [Lp(a)] is associated with atherosclerotic and thrombotic vascular diseases.

The aim of the present study was to evaluate the association between plasma Lp (a) concentration and in-stent restenosis.

Patients and Methods : One hundred and 9 patients with successful elective coronary stent implantation underwent follow-up angiography at 24 ± 6 weeks.

Restenosis after stent implantation occurred in 38 patients.

Results : univariate analysis showed that the reference diameter of the lesion was smaller in the restenosis group (2 : 93 + 0.29mm) than in the no-restenosis group (3.21 + 0.43 mm) (p < 0.05).

The lesion was longer in the restenosis group (14.2 ± 5.3 mm) than in the no-restenosis group (11.6 ± 4.9 mm) (p < 0.05).

Plasma Lp (a) concentrations in the restenosis group (30.5 + 23.9 mg / dl) were higher than in the no-restenosis group (16.9 ± 11.1 mg / dl) (p < 0.01).

Other lipid concentrations were similar in both groups.

Among the plasma Lp (a) concentrations, the rate of restenosis (71.4 %) in the high Lp(a) group (> 40 mg / dl) (n = 14) was greater compared with the other groups: 33.3% in the intermediate Lp (a) group (10-40 mg / dl) (n = 54), and 24.4 % in the low Lp (a) group (<10 mg / dl) (n = 41) (po.01).

The late loss (0.57+0.53 mm) in the low Lp (a) group was significantly less than the other groups : 0.88 ± 0.47mm in the intermediate Lp (a) group, and 1.08 ± 0.56 mm in the high Lp (a) group (p < 0.05).

In a multivariate regression model, plasma Lp (a) concentration remained significant as an independent predictor of restenosis in patients undergoing stent implantation (p = 0.020 odds ratio (OR) 1.37 95 %conficence interval (CI) 1.050-1.793), although the reference diameter (p-0.025 OR 0.23 95 %CI 0.061-0.830) and lesion length (p=0.021 OR 1.12 95 %CI 1.017-1.232) were related to stent restenosis.

Conclusions Plasma Lp (a) concentration is an independent risk factor of in-stent restenosis, although there is a relationship between the reference diameter, lesion length and restenosis.