Effect of Lp(a) on in-stent restenosis and non-target coronary lesions in CAD patients with drug-eluting stents
10.11855/j.issn.0577-7402.2019.10.07
- VernacularTitle: 脂蛋白(a)水平对冠心病患者药物洗脱支架置入术后支架内再狭窄及非靶病变的影响
- Author:
Jie-wen LI
1
Author Information
1. Department of Cardiology, Huiqiao Medical Center, Nanfang Hospital of Southern Medical University
- Publication Type:Journal Article
- Keywords:
Coronary artery disease;
Drug-eluting stent;
In-stent restenosis;
Lipoprotein(a);
Non-target coronary lesions
- From:
Medical Journal of Chinese People's Liberation Army
2019;44(10):851-856
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the effect of lipoprotein(a) [Lp(a)] on in-stent restenosis and non-target coronary lesions in coronary artery disease (CAD) patients implanted with drug-eluting stents. Methods One hundred and seventy-four patients, diagnosed as CAD and underwent percutaneous coronary intervention (PCI) with the implantation of drug-eluting stents (DES), were enrolled in present study; all of them were performed another elective PCI or revascularization within 1-4 years after their previous procedures. Thirty-one of enrolled patients were discovered to have in-stent restenosis. The relationship between Lp(a) and in-stent restenosis and the development of non-target coronary lesions were analyzed in groups stratified by the presence of in-stent stenosis or Lp(a) levels, and the independent risk factors of both in-stent restenosis and non-target lesions were also analyzed by multivariate logistic regression analysis. Results In CAD patients with DES, Lp(a) level in patients with in-stent restenosis showed a significant increase than those with the Lp(a) level non-restenosis [(437.57±391.60) mg vs. (279.46±288.06) mg, P=0.04]. In following analysis comparing lipid profiles and coronary angiography results between low and high Lp(a) groups, the percentage of triple-vessel disease and left main plus triple-vessel disease appeared to be statistically higher in high Lp(a) group than those in low Lp(a) group (P=0.022). Multivariate logistic regression analysis revealed that high level of Lp(a) and much number of stents implanted were the independent risk factors for in-stent restenosis of DES. In comparing the characteristics of coronary angiography and results of quantitative coronary angiography, number of cases with non-target lesions, presence of in-stent restenosis, minimal lumen diameter and in-stent late lumen loss were all significantly higher in high Lp(a) group than those in low Lp(a) group (P<0.05), and high level of Lp(a) was again proved to be an independent risk factor for non-target lesions in patients with DES (P=0.001). Conclusion Elevated Lp(a) level is an independent risk factor for both in-stent restenosis and the development of non-target coronary lesions, and is closely related to the relapse and aggravation of coronary artery disease.
