May High Serum Triglyceride Levels be a Predictor of New Silent Ischemic Lesions Detected with DW-MRI After Carotid Stenting?

INTRODUCTION: Silent ischemic lesions(CIL) frequently occur after carotid artery stenting(CAS) and are associated with poor long-term prognosis. The effect of blood triglyceride (TG) level on CIL after CAS is yet clear. We investigated the effect of serum TG level on post-procedure CIL in patients undergoing CAS. METHODS: 57 patients who underwent CAS were included in the study, and diffusion-weighted magnetic resonance imaging was conducted before and after CAS. The primary endpoint was new CILs after CAS. The effects of pre-procedural TG, total cholesterol, HDL, and LDL levels on the primary endpoint were investigated. RESULTS: Of the patients 46 (80.7%) were male, median age was 69(60-73) years, and 27 (47.3%) were symptomatic. After the procedure, ipsilateral new CILs were detected in 28 (49.1%) patients. NASCET stenosis %, being symptomatic and using aspirin before the procedure were associated with the presence of new ipsilateral CILs. In multivariate logistic regression analysis, pre-procedural TG level was the only independent predictor of ipsilateral new CILs after the procedure. DISCUSSION AND CONCLUSION: Our study reveals that high TG level is an independent risk factor for new CILs after CAS. Since CILs increase the risk for future ischemic events, TG as a simple, inexpensive, effective, and modifiable marker, can provide information for intense medical treatment, early intervention, and the prognosis.