Objectives: Insulin resistance or inflammation is known to be related with lipoprotein lipase activity and these factors are also closely associated with the pathogenesis of bare-metal stent restenosis. This study examined the relationship between preheparin lipoprotein lipase protein (preheparin LpL mass) concentration in serum and bare-metal stent restenosis.
Methods: A total of 121 lesions in 112 patients who underwent bare-metal stent implantation using NIR stent or S660/670 stent were examined. Subjects were divided into two groups (N group; patients with normal preheparin LpL mass concentration, n = 50 or L group; patients with low preheparin LpL mass concentration, n = 71) according to the mean levels of preheparin LpL mass concentration (male 39.3 ng/ml, female 50.6 ng/ml).
Results: There were no differences in percutaneous coronary intervention or angiographical characteristics. The L group had a significantly higher incidence of restenosis rate and target lesion revascularization than the N group (N group vs L group: 8.0% vs 42.3%, p < 0.0001; 8.0% vs 33.8%, p = 0.0008, respectively). Homeostatic model assessment of insulin resistance as a marker of insulin resistance and high sensitive C-reactive protein concentration were significantly higher in the L group than the N group. Multiple regression analysis showed that only low preheparin LpL mass concentration was an independent factor for restenosis (t value = 3.6, p = 0.0005).
Conclusions: Preheparin LpL mass concentration is closely associated with bare-metal stent restenosis and preheparin LpL mass concentration may be an important marker for the selection of bare-metal stent or drug-eluting stent.