Elevated Lipoprotein (a) in Carotid Artery Atherosclerosis is Unrelated to Restenosis After Endarterectomy

To investigate whether lipoprotein (a) (Lp[a]) is a risk factor for the development of carotid artery atheroma and restenosis after endarterectomy, 100 consecutive patients who had undergone endarterectomy were studied with repeat carotid Doppler ultrasonic scans to assess restenosis. The authors recorded history of vascular disease, medications, and smoking habits. Fasting samples were analyzed for serum total cholesterol, high-density lipoprotein cholesterol, triglycerides, apolipoprotein A1 and B, urate, glucose, and Lp(a). Carotid artery stenosis was associated with higher levels of Lp(a) (390 +/- 40 vs 142 +/- 30 mg/L for controls, mean +/-SEM, P < 0.05), and concentrations were 45% higher (P < 0.05) in the 39 patients who had concomitant peripheral vascular disease. During follow-up (twenty-four to one hundred sixty-eight months) 23% of patients restenosed and the median time to restenosis was one hundred ten months. Cigarette smoking, hypertension, and previous myocardial infarction were weakly associated (P=0.1) with restenosis, but no association was found between Lp(a) levels and restenosis after endarterectomy.