Low High Densit Lipoprotein Level Is Associated With Increased Restenosis Rate After Coronary Angioplast

Background. To determine the relation of post-percutaneous transluminal coronary angioplasty (PTCA) restenosis to serum lipid fractions and to circulating levels of endogenous tissue plasminogen activator (t-PA) and its rapid inhibitor (PAI-1), 68 patients with coronary artery disease who underwent a successful PTCA were studied. Methods and Results. During a mean follow-up of 9 months (range, 7-11 months), 28 (41%) patients developed restenosis. A low high density lipoprotein (HDL) cholesterol level was independently and strongly related to both the risk of restenosis (p<0.001) and to the time of restenosis (p=0.03). The mean HDL cholesterol level was 33+12 mg%o in the restenosis group compared with 45+±12 mg%Yo in the nonrestenosis group (p<0.001). Restenosis developed in 22 of 34 (64%) patients with an HDL cholesterol <40 mg%Yo compared with six of34 (17%) patients with an HDL cholesterol >40 mg%o (p <0.002). The only other variable that was significantly related to restenosis was a low PAI-1 level (p=0.04). Conclusions. The strong relation between a low HDL cholesterol level and the risk of restenosis suggests that lipid fractions could be important in the pathogenesis and prevention of restenosis. (Circulation 1992;85:1279-1285)