Luminal loss and restenosis after coronary angioplasty. The role of lipoproteins and lipids

Jørgensen, Bjørn; Simonsen, Svein; Endresen, Knut; Forfang, Kolbjørn; Egeland, Thore; Høstmark, Arne T.; Thaulow, Erik

doi:10.1053/euhj.1999.1578

Cited by 12 publications

(1 citation statement)

References 45 publications

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“…The importance of Lp(a) in secondary prevention has not been as thoroughly investigated. The association between Lp(a) and angiographically assessed progression of CAD [12, 13], restenosis after percutaneous transluminal coronary angioplasty (PTCA) [14‐18, 31,32] and CABG [19] have been investigated, but results have been inconclusive.…”

Section: Discussionmentioning

confidence: 99%

Is lipoprotein(a) a predictor for survival in patients with established coronary artery disease? Results from a prospective patient cohort study in northern Sweden

Glader

Birgander

Stenlund

et al. 2002

Journal of Internal Medicine

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. Ahlbeck Glader C, Slunga Birgander L, Stenlund H, Dahlén GH (Umeå University, Umeå, Sweden). Is lipoprotein(a) a predictor for survival in patients with established coronary artery disease? Results from a prospective patient cohort study in northern Sweden. J Intern Med 2002; 252: 27–35. Objectives. Lipoprotein(a) [Lp(a)] is a known risk factor for the development of atherosclerosis. The aim of the present study was to test the importance of Lp(a) as a predictor for the further prognosis in patients with established coronary artery disease. Design. A prospective patient cohort study was carried out. Setting and subjects. The cohort consists of 1216 patients who were examined with coronary angiography at the University Hospital in Umeå, Sweden, because of stable effort angina. Main outcome measures. Lipids, Lp(a), fibrinogen, antithrombin III (AT III), sedimentation rate and clinical data were registered at angiography. After a mean follow‐up time of 6.7 years information on survival was collected from the municipal census lists and death certificates were examined. Total mortality and mortality because of cardiovascular disease were both used as outcome variables in the survival analyses. Results. The total mortality in the patient cohort was 16.4%. An Lp(a) level of 300 mg L−1 or more was found in 30% of the study population and was found to be an independent predictor for death. A high fibrinogen, a low AT III level, a depressed left ventricular function and a high coronary obstruction score were other significant independent predictors of death. Total cholesterol, HDL‐ and LDL‐cholesterol were not related to survival in this study, but a substantial proportion of the population probably received lipid‐lowering agents during the study period. Conclusions. An Lp(a) level exceeding 300 mg L−1 indicates a poor further prognosis and may help to identify patients who probably need powerful secondary prevention programmes to improve their prognosis.

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Section: Discussionmentioning

confidence: 99%

Is lipoprotein(a) a predictor for survival in patients with established coronary artery disease? Results from a prospective patient cohort study in northern Sweden

Glader

Birgander

Stenlund

et al. 2002

Journal of Internal Medicine

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Coronary Restenosis

Aitsebaomo¹,

Moser²,

Smyth³

et al.

Contemporary Cardiology

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Association of lipoprotein(a) concentration and apo(a) isoform size with restenosis after percutaneous transluminal coronary angioplasty

et al. 2000

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Lp(a) is a unique class of lipoprotein particles that exhibits a considerable size heterogeneity resulting from the size polymorphism of apo(a), its unique protein component. An elevated level of Lp(a) in plasma has been proposed to be a risk factor for premature development of coronary artery disease. To evaluate the relationship between Lp(a) concentration and apo(a) isoform size with restenosis after percutaneous transluminal coronary angioplasty, Lp(a) levels and apo(a) phenotypes were determined in 204 patients who underwent a successful coronary angioplasty procedure and stent implantation. The patients were followed with clinical examinations and exercise tests at 1, 3, and 6 months, and a control coronary angiography was performed after 6 months to evaluate restenosis. Lp(a) levels were determined with an ELISA that is insensitive to the size heterogeneity of Lp(a), and the apo(a) isoforms were determined by a high-resolution agarose gel electrophoresis method followed by immunoblotting with a specific monoclonal antibody. Of the 146 patients who underwent angiographic evaluation, 57 (39%) had restenosis, whereas 89 (61%) did not. Lp(a) levels and the distribution of the expressed apo(a) phenotypes were compared in these two groups of patients. Although the mean and median Lp(a) levels were higher in the restenosed group, the difference was not statistically significant. However, a significant difference in Lp(a) values was found in women (P=0.043), even though, because of the small number of women in the study (n=35), no sound conclusions can be reached on the predictive role of Lp(a) in restenosis. There also was no difference in the distribution of apo(a) phenotypes between the two groups. Because of their wide distribution, Lp(a) values and apo(a) isoforms do not seem to be a useful indicator of risk of restenosis after percutaneous transluminal coronary angioplasty in our study cohort.

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Luminal loss and restenosis after coronary angioplasty. The role of lipoproteins and lipids

Abstract: Lipoproteins and lipids were neither associated with luminal loss nor independent risk factors for restenosis after angioplasty.

Cited by 12 publications

References 45 publications

Is lipoprotein(a) a predictor for survival in patients with established coronary artery disease? Results from a prospective patient cohort study in northern Sweden

Is lipoprotein(a) a predictor for survival in patients with established coronary artery disease? Results from a prospective patient cohort study in northern Sweden

Coronary Restenosis

Association of lipoprotein(a) concentration and apo(a) isoform size with restenosis after percutaneous transluminal coronary angioplasty

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