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Elevated Lipoprotein (a) in Carotid Artery Atherosclerosis is Unrelated to Restenosis After Endarterectomy

Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St. James's Hospital, Dublin, Ireland

Glenn D'Arcy, B.Sc

Thomas Cooke, F.I.M.L.S.

Department of Biological Science, Institute of Technology, Dublin, Ireland

Mary Paula Colgan, M.D.

Department of Vascular Surgery, Trinity Centre for Health Sciences, St. James's Hospital, Dublin, Ireland

Mary Hall, R.G.N.

Janette Tyrrell, M.R.C.P.I.

Karl Gaffney, M.R.C.P.I.

Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St. James's Hospital, Dublin, Ireland

Maria Grouden

Dermot Moore, F.R.C.S.I.

Donald Gregor Shanik, F.R.C.S.I.

Department of Vascular Surgery, Trinity Centre for Health Sciences, St. James's Hospital, Dublin, Ireland

John Feely, M.D.

Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St. James's Hospital, Dublin, Ireland

To investigate whether lipoprotein (a) (Lp[a]) is a risk factor for the development of carotid artery atheroma and restenosis after endarterectomy, 100 consecutive patients who had undergone endarterectomy were studied with repeat carotid Doppler ultrasonic scans to assess restenosis. The authors recorded history of vascular disease, medications, and smoking habits. Fasting samples were analyzed for serum total cholesterol, high-density lipoprotein cholesterol, triglycerides, apolipoprotein Al and B, urate, glucose, and Lp(a). Carotid artery stenosis was associated with higher levels of Lp(a) (390 ±40 vs 142 ±30 mg/L for controls, mean ±EM, P < 0.05), and concentrations were 45% higher (P < 0.05) in the 39 patients who had concomitant peripheral vascular disease. During follow-up (twenty-four to one hundred sixty-eight months) 23% of patients restenosed and the median time to restenosis was one hundred ten months. Cigarette smoking, hypertension, and previous myocardial infarction were weakly associated (P=0.1) with restenosis, but no association was found between Lp(a) levels and restenosis after endarterectomy.

Vascular and Endovascular Surgery, Vol. 29, No. 1, 23-27 (1995)
DOI: 10.1177/153857449502900103


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