Risk factors for restenosis after percutaneous transluminal coronary angioplasty: Role of lipoprotein (a)

To evaluate serum levels of lipoprotein (a) (Lp[a]) as a predictor of restenosis after percutaneous transluminal coronary angioplasty (PTCA), we evaluated 71 patients who underwent elective single-vessel angioplasty. Patients were divided into two groups according to the presence (n = 24 [34%]; group R) or absence (n = 47 [66%]; group N) or restenosis. Serum insulin levels were similar before and after the glucose challenge test in both groups. The median level of serum Lp(a) was 34.9 mg/dl in group R compared with 19.4 mg/dl in group N (p < 0.01). The frequency of the apo E4 allele was 4 (17%) in group R and 4 (9%) in group N (p = NS). The incidence of restenosis was significantly higher in patients with Lp(a) levels ≥30 mg/dl than in those with Lp(a) levels <30 mg/dl (65% vs 26%; p < 0.01). Our results indicate that a serum Lp(a) level ≥30 mg/dl is a risk factor for restenosis.