SERUM-LIPIDS AND RESTENOSIS AFTER SUCCESSFUL PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY

The effects of plasma lipids on the clinical and angiographic paramete rs of 134 patients, in whom coronary angioplasty was performed in 157 vessels, were prospectively examined. During a 6-month follow-up, rest enosis was detected angiographically in 39 patients (29%; 45 vessels). None of the clinical, biochemical, or angiographic variables examined was predictive of stenosis and the tendency of a vessel to restenose was not patient-dependent but rather lesion-related. However, restenos is developed in 31 of 102 vessels (30%) in patients With high-density lipoprotein (HDL) cholesterol less than or equal to 40 mg/dl, compared with restenosis in 10 of 55 vessels (19%) in patients with HDL choles terol >40 mg/dl (p = 0.092). No significant differences were observed when restenosis rates were com- pared in patients with total cholester ol levels >250 mg/dl or <250 mg/dl; no differences were seen is low-de nsity lipoprotein (LDL) cholesterol levels when comparing patients wit h >160 mg/dl and <160 mg/dl. In 117 patients (132 vessels), complete s erial blood specimens were obtained until the concluding angiography a t 6 months. During follow-up, both groups (those with and without rest enosis) had almost similar findings. Triglycerides decreased equally i n both groups, and total cholesterol increased mildly in those who had restenosis; HDL and LDL cholesterol levels increased significantly in each group. No significant differences were observed with respect to extent of these changes between the groups. Thus, although lipid level s at the time of angioplasty and at 6 months follow-up were not found to predict the occurrence of restenosis, the association of low high-d ensity lipoprotein levels and the tendency for restenosis should not b e overlooked.