ELEVATED LIPOPROTEIN (A) IN CAROTID-ARTERY ATHEROSCLEROSIS IS UNRELATED TO RESTENOSIS AFTER ENDARTERECTOMY

To investigate whether lipoprotein (a) (Lp[a]) is a risk factor for th e development of carotid artery atheroma and restenosis after endarter ectomy, 100 consecutive patients who had undergone endarterectomy were studied with repeat carotid Doppler ultrasonic scans to assess resten osis. The authors recorded history of vascular disease, medications, a nd smoking habits. Fasting samples were analyzed for serum total chole sterol, high-density lipoprotein cholesterol, triglycerides, apolipopr otein A1 and B, urate, glucose, and Lp(a). Carotid artery stenosis was associated with higher levels of Lp(a) (390 +/- 40 vs 142 +/- 30 mg/L for controls, mean +/-SEM, P < 0.05), and concentrations were 45% hig her (P < 0.05) in the 39 patients who had concomitant peripheral vascu lar disease. During follow-up (twenty-four to one hundred sixty-eight months) 23% of patients restenosed and the median time to restenosis w as one hundred ten months. Cigarette smoking, hypertension, and previo us myocardial infarction were weakly associated (P=0.1) with restenosi s, but no association was found between Lp(a) levels and restenosis af ter endarterectomy.