Lipoproteins and the Development of Restenosis After Stent Implantation in the Superficial Femoral Artery in Patients with Peripheral Artery Disease

Abstract

High levels of apolipoprotein B (apo B) are a risk factor for the development of major vascular events. We evaluated the association between plasma lipoproteins and the development of superficial femoral artery (SFA) in-stent restenosis and reocclusion in patients with peripheral artery disease. We included 139 patients with SFA stenting. Plasma lipoproteins were measured after stent implantation. Stent restenosis was assessed with duplex scan after 3, 6, and 12months. A stenosis grade was considered relevant if >50%. Seventy-two patients experienced recurrence of their atherosclerotic disease, meaning restenosis of >50% within 1year of follow-up. Ten of these patients had a stent occlusion. In the patients who experienced recurrence, the mean apo B level was 105.8 versus 94.9mg/dl in patients without recurrence (P<0.05). Patients without recurrence had higher high-density lipoprotein cholesterol levels than patients with recurrence (39.7 vs. 34.7mg/dl, P<0.05). Comparing patients with a stent occlusion (n=10) and those with a restenosis of 75-99% (n=28), the patients with a stent occlusion had higher levels of plasma cholesterol (234.1 vs. 185.9mg/dl, P<0.05), apo B (135.3 vs. 99.8mg/dl, P<0.05), low-density lipoprotein cholesterol (160.3 vs. 113.6mg/dl, P<0.05), and low-density lipoprotein apo B (115.5 vs. 82.4mg/dl, P<0.001) than the patients with restenosis of 75-99% (n=28). Changes in the lipid profile could be one reason for the development of restenosis and for the development of reocclusion after SFA stenting.