High low‐density lipoprotein cholesterol as an independent risk factor for coronary restenosis in hemodialysis patients undergoing percutaneous coronary interventions

Abstract

HD patients have been reported to have a higher risk of restenosis after percutaneous coronary intervention (PCI). The aim of this study was to investigate the risk factors of coronary restenosis in HD patients. We enrolled 54 HD patients (mean age: 66.5 ± 10.1 years; 72.2% men; mean HD duration: 3.7 years), who received PCI and follow‐up coronary angiography. Of the patients, 22 (40.7%) had restenosis within 3 to 12 months of PCI. Univariate logistic analysis showed low‐density lipoprotein cholesterol (LDL‐C)/high‐density lipoprotein cholesterol (HDL‐C) ratio, LDL‐C, non‐HDL‐C, and history of major adverse cardiovascular events were significantly associated with coronary restenosis (OR]: 1.89, 1.27, 1.22, and 5.79, respectively). Multivariate analysis showed that LDL‐C was significantly associated with coronary restenosis (OR: 1.43). These data suggest that LDL‐C is an independent risk factor for coronary restenosis in HD patients undergoing PCI, and strict lipid management may be required.

Computational modeling of low‐density lipoprotein accumulation at the carotid artery bifurcation after stenting

“…LDL accumulation is also suggested to promote plaque formation in the aorta 32–34 and carotid artery 35–38 . In the case of restenosis, recent reports suggest that the process starts with neoatherosclerosis after stenting, characterized by the accumulation of lipid‐laden foamy macrophages within the neointimal layer 39–42 . Therefore, early accumulation of LDL could be the most crucial reason for intimal thickening, which is the first step of arterial narrowing (initiation of intimal thickening).…”