ASSOCIATION OF HIGH LIPOPROTEIN(a) LEVELS WITH CORONARY ARTERY PATENCY DURING THE FIRST YEAR AFTER PERCUTANEOUS CORONARY INTERVENTIONS

• Main Authors: M. V. Ezhov, M. S. Safarova, Yu. G. Matchin, D. I. Soboleva, O. I. Afanasyeva, S. N. Pokrovsky
• Format: Article
• Language: Russian
• Published: ABV-press 2014-07-01
• Series: Klinicist
• Subjects: coronary heart disease; risk factors; lipoprotein(a); percutaneous coronary interventions; progression of atherosclerosis; restenosis
• Online Access: http://klinitsist.abvpress.ru/index.php/Klin/article/view/132

<p><strong>Objective:</strong> to study an association of high lipoprotein(a) [Lp(a)] levels with the development of restenosis and the progression of coronary<br />atherosclerosis after percutaneous coronary interventions (PCI) in patients with chronic coronary heart disease (CHD).</p><p><br /><strong>Subjects and methods.</strong> From 502 enrolled patients (mean age 54.7 ± 8.9 years), 92 underwent routine percutaneous transluminal coronary angioplasty (PTCA), 270 had PTCA with the bare metal stent (BMS) being implantation, 140 had PTCA using drug-eluting stents (DES). Functional<br />classes III and IV angina have been registered in 337 (67 %) patients; history of one myocardial infarction (MI) was noted in 234 (47 %) cases, 171 (34 %) had experienced 2 or more MIs. Blood samples for lipid and Lp(a) measurements were taken in all the patients. Restenosis was defined as at least 50 % lumen narrowing of the coronary artery segment after angioplasty. Coronary atherosclerosis progression was established in cases of the new occlusion occurring, as well as identifying a 10 % decrease in lumen diameter in comparison with baseline angiograms.</p><p><br /><strong>Results.</strong> Repeated coronary angiography revealed the signs of restenosis in 103 of 243 patients. Dividing patients into 3 groups according to the type of intervention demonstrated that the level of Lp(a) (median 25–75 % quartiles) was significantly higher in the restenosis group after implantation of BMS (33; 11–62 and 16; 6–39 mg/dl, respectively; p = 0.014) versus those who had undergone DES implantation (23; 10–30 and 20; 6–60 mg/dl; p = 0.7) or balloon angioplasty (17; 4–48 and 9; 4–36 mg/dl; p = 0.3). Patients with progression of coronary atherosclerosis had difference only in Lp(a) levels compared to the group without progression (36; 13–62 versus 12; 4–26 mg/dl, p &lt; 0,001.</p><p><br /><strong>Conclusion.</strong> During the first year after elective PCI Lp(a) concentration determined the severity of coronary atherosclerosis in non-culprit lesions<br />and associated with the risk of in-stent restenosis after BMS, independly of conventional risk factors.</p>