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(Circulation. 1998;98:1172-1177.)
© 1998 American Heart Association, Inc.

Clinical Investigation and Reports

Plasma Lipoprotein(a) Is Not a Predictor for Restenosis After Elective High-Pressure Coronary Stenting

Flavio Ribichini, MD; Giuseppe Steffenino, MD; Antonio Dellavalle, MD; Antonello Vado, MD; Valeria Ferrero, MD; Terenzio Camilla, BS; Silvia Giubergia, BS; ; Eugenio Uslenghi, MD

From the Cardiac Catheterization Unit (F.R., G.S., A.D.), Division of Cardiology (A.V., V.F., E.U.), and Laboratory for Clinical Biochemistry (T.C., S.G.), Ospedale Santa Croce, Cuneo, Italy.

Correspondence to Giuseppe Steffenino, MD, Laboratorio di Emodinamica, Ospedale Santa Croce, Via Michele Coppino 26, 12100 Cuneo, Italia. E-mail emodinam{at}www.lrcser.it

Background—Lipoprotein(a) is a risk factor for coronary artery disease. Although it has been implicated in restenosis after balloon angioplasty, its role in restenosis within coronary stents is unknown. The aim of the study was to assess the role of plasma lipoprotein(a) as a predictor for restenosis after elective coronary stenting.

Methods and Results—Elective, high-pressure stenting of de novo lesions in native coronary arteries with Palmaz-Schatz stents was performed in 325 consecutive patients. Clinical, angiographic, and biochemical data were analyzed prospectively. Angiographic follow-up was performed at 6 months. Lipoprotein(a) levels were compared in patients with and without restenosis. Angiographic follow-up was obtained in 312 patients (96%); recurrence was observed in 67 patients (21.5%). No clinical or biochemical variable was associated with restenosis. Lipoprotein(a) level was 37.81±49.01 mg/dL (median, 22 mg/dL; range, 3 to 262 mg/dL) in restenotic patients and 36.95±40.65 mg/dL (median, 22 mg/dL; range, 0 to 244 mg/dL) in nonrestenotic patients (P=NS). The correlations between percent diameter stenosis, minimum luminal diameter, and late loss at follow-up angiography and basal lipoprotein(a) plasma level after logarithmic transformation were 0.006, 0.002, and 0.0017, respectively. Multiple stents were associated with a higher incidence of restenosis (P=0.006), but biochemical data in these patients were similar to those treated with single stents.

Conclusions—The basal plasma level of lipoprotein(a) measured before the procedure is not a predictor for restenosis after elective high-pressure coronary stenting.

Key Words: stents • restenosis • lipoprotein(a)

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