Johansson S R, Wiklund O, Karlsson T, Hjalmarson A, Emanuelsson H
Department of Medicine I, University of Göteborg, Sweden.
Eur Heart J. 1991 Sep;12(9):1020-8. doi: 10.1093/eurheartj/12.9.1020.
Restenosis after coronary angioplasty (PTCA) is a major problem, limiting the long-term efficacy of the procedure. Lipoprotein levels are associated with the development of atherosclerosis and may also be associated with restenosis. In this study the serum levels of cholesterol (CH), triglycerides (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) were analysed in 157 patients undergoing 161 PTCA procedures. Follow-up coronary angiograms were performed after 6.0 +/- 4.3 months. The restenosis rate was 33%. Treatment with aspirin and a residual stenosis of 25-49% immediately after successful PTCA were the only variables associated with restenosis (P less than 0.05), otherwise the clinical and angiographic characteristics were similar with and without restenosis. There was no relationship between restenosis and the levels of CH, TG, HDL or LDL (P greater than 0.05). In univariate and multivariate analysis of males (n = 121) and females (n = 40) separately, restenosis was associated with low HDL in men and high HDL in women (P less than 0.05), but not with CH, TG or LDL (P greater than 0.05). We conclude that the serum levels of CH, TG and LDL do not seem to be related to restenosis after PTCA. It is suggested that low HDL in males and high HDL in females is related to restenosis.
冠状动脉血管成形术(PTCA)后再狭窄是一个主要问题,限制了该手术的长期疗效。脂蛋白水平与动脉粥样硬化的发展相关,也可能与再狭窄有关。在本研究中,对157例接受161次PTCA手术的患者的血清胆固醇(CH)、甘油三酯(TG)、高密度脂蛋白(HDL)和低密度脂蛋白(LDL)水平进行了分析。在6.0±4.3个月后进行了随访冠状动脉血管造影。再狭窄率为33%。成功PTCA后立即使用阿司匹林治疗和残余狭窄25%-49%是与再狭窄相关的唯一变量(P<0.05),否则有无再狭窄的临床和血管造影特征相似。再狭窄与CH、TG、HDL或LDL水平之间无相关性(P>0.05)。分别对男性(n=121)和女性(n=40)进行单因素和多因素分析,结果显示,再狭窄与男性低HDL和女性高HDL相关(P<0.05),但与CH、TG或LDL无关(P>0.05)。我们得出结论,血清CH、TG和LDL水平似乎与PTCA后的再狭窄无关。提示男性低HDL和女性高HDL与再狭窄有关。