LIPOPROTEIN(A) IN RESTENOSIS AFTER PERCUTANEOUS TRANSLUMINAL CORONARYANGIOPLASTY AND CORONARY-ARTERY DISEASE

Background The purpose of the study was to investigate the relation of lipoprotein(a), and serum lipid parameters to restenosis after percut aneous transluminal coronary angioplasty (PTCA) and to assess the asso ciation of these same biochemical markers to coronary artery disease ( CAD) in individuals with angiographically defined normal and diseased coronary arteries. Methods and Results Sixty-two patients with success ful PTCA had follow-up angiography at 35+/-10 weeks. Restenosis occurr ed in 21 male patients (46%) and 6 female patients (38%). Elevated apo lipoprotein B (P<.01) and decreased high-density lipoprotein-2 cholest erol (P<.02) were found to be independently associated with restenosis after angioplasty, whereas lipoprotein(a) was not. Eighty-five patien ts undergoing PTCA were compared with 46 subjects who had no evidence of CAD on angiography. Elevated lipoprotein(a) (P<.001) and reduced ap olipoprotein Al to B ratio (P<.001) were found to be strong independen t risk factors for the presence of CAD when adjustment was made for ag e (P<.005), male sex (P<.01), smoking (P<.005), and hypertension (P=.0 6). Conclusions Serum lipoprotein(a) levels are not associated with re stenosis after PTCA, but elevated levels are strongly associated with CAD. Low-serum, high-density lipoprotein-2 cholesterol concentration a nd elevated apolipoprotein B concentration were found to be associated with restenosis after PTCA.