Usefulness of serum lipoprotein (a) as a predictor of restenosis after percutaneous transluminal coronary angioplasty

Hearn, James A.; Donohue, Bryan; Ba'albaki, Hisham; Douglas, John S.; King, Spencer B.; Lembo, Nicholas; Roubin, Gary S.; Sgoutas, Demetrios S.

doi:10.1016/0002-9149(92)90497-m

Cited by 107 publications

(27 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Most of the previously published studies addressing the issue had methodological defects or constraints limiting the usefulness of the results. Various limitations of these studies included retrospective analysis 10,16 ; small sample size 9,11,14,15,18 ; inclusion of patients and measurement of Lp(a) within 4 weeks of acute myocardial infarction, 10,12 which increases Lp(a) for at least 4 weeks 21,23 ; blood sampling after PTCA 9,10,12,16 ; the interventional nature of the study 17 ; or assay of stored samples, 13 which can yield artifactually low levels of Lp(a).…”

Section: Discussionmentioning

confidence: 99%

Lipoprotein(a) Level Does Not Predict Restenosis After Percutaneous Transluminal Coronary Angioplasty

Alaigh

Hoffman

Korlipara

et al. 1998

ATVB

View full text Add to dashboard Cite

Abstract-The serum lipoprotein(a) [Lp(a)] level is a known risk factor for arteriosclerotic coronary artery disease.However, its association with restenosis after percutaneous transluminal coronary angioplasty (PTCA) is controversial. We hypothesized that the Lp(a) level is a significant risk factor for restenosis after angioplasty through a pathophysiological mechanism leading to excess thrombin generation or inhibition of fibrinolysis. We designed a prospective study of the relation of Lp(a) to outcome after PTCA, in which we measured selected laboratory variables at entry and collected clinical, procedural, lesion-related, and outcome data pertaining to restenosis. Restenosis was defined as Ͼ50% stenosis of the target lesion by angiography or as ischemia in the target vessel distribution by radionuclide-perfusion scan. Before the patients underwent PTCA, blood was obtained by venipuncture for measurement of Lp(a), total cholesterol, thrombin-antithrombin (TAT) complex, ␣ 2 -antiplasmin-plasmin (APP) complex, and plasminogen activator inhibitor-1 (PAI-1). Evaluable outcome data were obtained on 162 subjects, who form the basis of this report. Restenosis occurred in 61 subjects (38%). The Lp(a) level was not correlated significantly with TAT, APP, PAI-1, or the TAT-APP ratio. Levels of TAT, APP, and PAI-1 were not statistically different in the patients with versus those without restenosis. The median ratio of TAT to APP was 2-fold higher in the restenosis group, and this difference approached statistical significance (Pϭ0.07). Univariate analysis was performed for the association of clinical, lesion-related, and procedural risk factors with restenosis. Lp(a) levels did not differ significantly in the restenosis versus no-restenosis group, whether assessed categorically (Ͼ25 mg/dL versus Ͻ25 mg/dL) or as a continuous variable by Mann-Whitney U test. The number of lesions dilated and the lack of family history of premature heart disease were significantly associated with restenosis (Pϭ0.002 and Pϭ0.008, respectively). A history of diabetes mellitus was of borderline significance (Pϭ0.055). By multiple logistic regression analysis, the number of lesions dilated was the only variable significantly associated with restenosis (Pϭ0.03). We conclude that the number of lesions dilated during PTCA is a significant risk factor for restenosis, whereas the serum Lp(a) level was not a significant risk factor for restenosis in our patient population. The TAT to APP ratio merits further study as a possible risk factor for restenosis. (Arterioscler Thromb Vasc Biol. 1998;18:1281-1286.)Key Words: lipoprotein(a) Ⅲ angioplasty Ⅲ thrombin Ⅲ plasmin Ⅲ antiplasmin P ercutaneous transluminal coronary angioplasty (PTCA) has become a standard procedure for the treatment of coronary artery disease. However, in spite of advances in techniques, restenosis after PTCA remains a common complication, at a rate of 30% to 40% in the absence of stent placement.1-4 Various risk factors predictive of restenosis have been identified, and these can ...

show abstract

Section: Discussionmentioning

confidence: 99%

Lipoprotein(a) Level Does Not Predict Restenosis After Percutaneous Transluminal Coronary Angioplasty

Alaigh

Hoffman

Korlipara

et al. 1998

ATVB

View full text Add to dashboard Cite

show abstract

“…An elevated Lp(a) level is a risk factor for coronary heart disease [2 6], stenosis of saphenous vein graft [7] and restenosis after angioplasty [8,9]. Immunohistochemical staining with a specific antibody to apo(a) has shown a substantial amount of Lp(a) in human aortic atherosclerotic plaques [21].…”

Section: Discussionmentioning

confidence: 99%

“…Lipoprotein(a) (Lp(a)) discovered by Berg in 1963 [l] is believed to be a risk factor for coronary heart disease [2][3][4][5][6], vein graft stenosis after coronary artery bypass [7] and restenosis after percutaneous transluminal coronary angioplasty [8,9]. Lp(a) is an low density lipoprotein (LDL)-like particle with a characteristic polymorphic glycoprotein known as apolipoprotein(a) (apo(a)) that is disulfide linked to the apolipoprotein B moiety of LDL [10].…”

Section: Introductionmentioning

confidence: 99%

Lipoprotein(a) stimulates the proliferation of cultured human arterial smooth muscle cells through two pathways

et al. 1995

View full text Add to dashboard Cite

“…Hoff ve arkadaşları (15), koroner arter bypass (CABS) operasyonundan sonra tekrarlanan ven graft stenozlu hastalarda bağımsız risk faktörü olan Lp (a) run yüksek düzeylerde bulunduğunu bildirmiştir. Diğer taraftan yakın zamanda yapılan çalışmalar (127,128), restenozla sonuçlanan intimal veya düz kas hücre proliferasyonun başlaması ve gelişmesinde, LDLkolesterol gibi Lp (a) nın da rol aldığı şüphesini uyandırmıştır. Yamaguchi ve arkadaşları (129) LDL-aferezi uygulamasıyla elde edilen Lp (a) redüksiyonunun % 50 den daha düşük olduğu durumlarda uygulamanın niceritrol ve pravastation gibi lipid düşürücü ilaçlarla birlikte yapılmasının daha etkili olduğunu bildirmiştir.…”

Section: Ldl -Ve Lp (A) -Aferez Uygulamalarının Plazma Lp (A) Düzeyleunclassified

Diyet, Farmakolojik Ajanlar ve Aferez Uygulamalarının Plasma Lipoprotein (a) Düzeyleri Üzerindeki Etkileri : The Effects of Diet, Pharmacological Agents and Apheresis Procedures on Plasma Levels of Li

Burat¹

1995

Ankara Universitesi Eczacilik Fakultesi Dergisi

View full text Add to dashboard Cite

ÖZETYüksek plazma Lp (a) konsantrasyonu ile aterosklrıotik damar hastalıkları gelişimi arasındaki ilişkiyi gösteren epiderniyolojik kanıt lar ve yakın zamanda yapılan biyokimyasal çalışmalar, plazma Lp (a) konsantrasyonlarının düşürülmesinde büyük bir ilgi uyandırmıştır. Bu makalenin amacı, plazma Lp (a) konsantrasyonlarını güvenli düzeylere indirmede kullanılacak araçların tesbitiyle ilgili çalışmaları gözden geçirerek tartışmaktır.Anahtar kelimeler: Diyet, Farmakolojik ajanlar, Aferez, Lipopro tein (a) SUMMARY The epidemiological evidence and the recent biochemical studies which show association between elevated plasma concentrations of lipoprotein (a) (Lp (a)) and the development of atherosclerotic vascular disease, have stimulated a great deal of interest in lowering plasma Lp (a) concentrations. The aim of this paper is to rewiev and discuss the studies in identifying means for bringing plasma Lp (a) concentrations down to safe levels.

show abstract

Usefulness of serum lipoprotein (a) as a predictor of restenosis after percutaneous transluminal coronary angioplasty

Cited by 107 publications

References 16 publications

Lipoprotein(a) Level Does Not Predict Restenosis After Percutaneous Transluminal Coronary Angioplasty

Lipoprotein(a) Level Does Not Predict Restenosis After Percutaneous Transluminal Coronary Angioplasty

Lipoprotein(a) stimulates the proliferation of cultured human arterial smooth muscle cells through two pathways

Diyet, Farmakolojik Ajanlar ve Aferez Uygulamalarının Plasma Lipoprotein (a) Düzeyleri Üzerindeki Etkileri : The Effects of Diet, Pharmacological Agents and Apheresis Procedures on Plasma Levels of Li

Contact Info

Product

Resources

About