Document Detail


Lipoprotein(a) and other serum lipid subfractions influencing primary patency after infrainguinal percutaneous transluminal angioplasty.
MedLine Citation:
PMID:  19642794     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate the influence of serum lipid subfraction concentrations on arterial patency after percutaneous transluminal angioplasty (PTA) in patients with infrainguinal peripheral artery occlusive disease (PAOD). METHODS: From January 2007 to June 2008, a prospective study was conducted involving 39 patients (29 men; mean age 68.6+/-10.0 years) with infrainguinal PAOD in 41 limbs who had preprocedural lipid assessment and underwent successful PTA (<30% residual stenosis). Patient demographics, Fontaine clinical stage classification, Texas University Classification of ulcers, coexisting medical conditions, endovascular procedures, and lipid profiles were collected in a database. Follow-up included clinical and duplex ultrasound evaluation at discharge and at 1, 3, 6, and 12 months. To analyze any correlation between various lipid subfractions and the loss of primary patency (Cox proportional hazards modeling), the patients were dichotomized into high and low groups according to these thresholds: LDL-C >100 mg/dL, HDL-C <40 mg/dL, Lp(a) >30 mg/dL, and an Apo(B)/Apo(A) ratio >0.8 mg/dL. RESULTS: Mean follow-up was 7.5 months (range 3-12). After 1, 3, and 6 months, the primary patency rates by Kaplan-Meier analysis were 94.9%, 73.7%, and 64.1%, respectively. Restenosis at 6 months was significantly related to female gender (HR 95.9, 95% CI 6.8 to 1352.5, p = 0.001), HDL-C <40 mg/dL (HR 86.9, 95% CI 6.4 to 1183.1, p = 0.001), LDL-C >100 mg/dL (HR 9.6, 95% CI 1.6 to 57.4, p = 0.013), and Lp(a) >30 mg/dL (HR 6.1, 95% CI 1.4 to 26.3, p = 0.016). CONCLUSION: Our results suggest that Lp(a), LDL-C, and HDL-C are independent risk factors for restenosis after infrainguinal PTA.
Authors:
Federica Giovanetti; Mauro Gargiulo; Luca Laghi; Sergio D'Addato; Filippo Maioli; Natascia Muccini; Claudio Borghi; Andrea Stella
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists     Volume:  16     ISSN:  1545-1550     ISO Abbreviation:  J. Endovasc. Ther.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-07-31     Completed Date:  2009-11-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100896915     Medline TA:  J Endovasc Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  389-96     Citation Subset:  IM    
Affiliation:
Department of Specialized Vascular Surgery and Anesthesiology, Alma Mater Studiorum, University of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon*
Arterial Occlusive Diseases / blood*,  therapy
Cohort Studies
Female
Graft Occlusion, Vascular / blood,  etiology*
Humans
Leg / blood supply*
Lipoproteins / blood*
Male
Middle Aged
Peripheral Vascular Diseases / blood*,  therapy
Retrospective Studies
Risk Factors
Stents
Treatment Outcome
Vascular Patency / physiology
Chemical
Reg. No./Substance:
0/Lipoproteins

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