Key result
A 1-month postprocedural HDL cholesterol level >45 mg/dl was an independent predictor of carotid stent patency at 1 year (OR 0.09; 95% CI 0.01-0.83; P=0.033).
Why the study?
Does postprocedural HDL cholesterol >45 mg/dl predict carotid stent patency at 1 year in patients undergoing carotid artery stenting?
Cohort (n=102)
Does postprocedural HDL cholesterol >45 mg/dl predict carotid stent patency at 1 year in patients undergoing carotid artery stenting?
Odds Ratio: 0.09 (95% CI 0.01–0.83)
p-value: p=0.033
Postprocedural HDL cholesterol levels >45 mg/dl independently predict carotid stent patency at 1 year, highlighting a potential metabolic target for improving long-term outcomes after carotid artery stenting.
Should not yet change post-stenting care; leaves open whether HDL optimization improves long-term patency.
The durability of carotid artery stenting (CAS) is affected by the occurrence of myointimal proliferation and in-stent restenosis (ISR). We aimed to identify clinical, angiographic, and laboratory predictors of ISR, paying special attention to postprocedural metabolic factors. A total of 102 consecutive patients with successful CAS for > or =70% atherosclerotic internal carotid artery stenosis were followed up with neurological assessment and duplex sonography 1 day, 1 month, and 1 year after CAS. Lipid profile and hemoglobin A(1c) were tested at the 1-month follow-up visit. Ten (10%) patients had ISR > or =50% after 1 year. Compared with patients without ISR (n = 92), patients with ISR were more often current smokers (33% vs. 70%, P = 0.034) and had significantly lower 1-month high-density lipoprotein (HDL) cholesterol: median (range) 47 (24-95) mg/dl vs. 39.5 (25-50) mg/dl, P = 0.031. Multivariate logistic regression analyses identified 1-month HDL cholesterol >45 mg/dl as the only independent predictor of carotid stent patency at 1 year (P = 0.033, OR = 0.09, 95% CI 0.01-0.83). Postprocedural HDL cholesterol levels predict carotid stent patency at 1 year. With the possibility of elevation of HDL cholesterol by lifestyle changes and medication, this finding may have implications for the future management of patients undergoing CAS.
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Topakian et al. (2008) conducted a cohort in Atherosclerotic internal carotid artery stenosis (n=102). 1-month HDL cholesterol >45 mg/dl vs. Lower HDL cholesterol was evaluated on Carotid stent patency at 1 year (OR 0.09, 95% CI 0.01-0.83, p=0.033). A 1-month postprocedural HDL cholesterol level >45 mg/dl was an independent predictor of carotid stent patency at 1 year (OR 0.09; 95% CI 0.01-0.83; P=0.033).
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