Effects of increasing particle size of low-density lipoprotein on restenosis after coronary stent implantation
Authors
Jung-Sun Kim ; Myung-Hyun Kim ; Byoung Kwon Lee ; Se-Joong Rim ; Pil-Ki Min ; Se-Jung Yoon ; Jeong-Ho Kim ; Ji-Hyuck Rhee ; Young Won Yoon ; Bum Kee Hong ; Hyuck Moon Kwon ; Changsoo Kim
Coronary stent ; Restenosis ; Small dense low-density lipoprotein
Abstract
BACKGROUND: Small dense low-density lipoprotein (LDL) has emerged as an important risk factor in coronary atherosclerosis and vascular inflammation, which is related to neointimal hyperplasia. Therefore, the aim of the present study was to investigate whether changes in LDL particle size are related to in-stent restenosis (ISR).
METHODS AND RESULTS: The LDL subfraction and lipid profiles were measured in 274 patients (412 stents) at both baseline and follow-up coronary angiography (CAG). The incidence of ISR (80 lesions, 19.4%) was lower in the patients with increased LDL particle size than in those with no change or decrease (14.2% vs 25.8%, p=0.004). Logistic multivariate analysis revealed that stent length (>or=24 mm) (odds ratio (OR) =1.913, p=0.027), post minimal luminal diameter (>3 mm) (OR =0.528, p=0.028), acute coronary syndrome (OR =2.294, p=0.005), decrease in high-density lipoprotein-cholesterol (OR =1.028, p=0.047) and increase in LDL particle size (OR =0.528, p=0.031) were independent predictors for ISR.
CONCLUSIONS: In the present study, an increase in the LDL particle size between baseline and follow-up CAG was associated with reduced incidence of ISR. Therefore, modification of LDL particle size may have a beneficial effect on the risk of ISR