Low-Density Lipoprotein Cholesterol Levels Are Associated With Subsequent Stented-Territory Ischemic Stroke After Carotid Artery Stenting: A Single Center Retrospective Study

Overview

Journal J Lipid Atheroscler

Date 2023 Jun 2

PMID 37265854

Authors

Seung Min Kim

Jae Chan Ryu

Sujin Koo

Jong S Kim

Bum Joon Kim

Affiliations

Soon will be listed here.

Abstract

Objective: The role of low-density lipoprotein cholesterol (LDL-C) after carotid artery stenting (CAS) is not well known with respect to stented-territory infarction (STI) and in-stent restenosis (ISR). We hypothesized that LDL-C levels after CAS might be independently associated with STI and ISR.

Methods: We conducted a retrospective study for patients with significant extracranial carotid stenosis who were subjected to CAS between September 2013 and May 2021. LDL-C levels were measured after 6 and 12 months following CAS. The association between STI and ISR, and LDL-C was explored using Cox proportional-hazard model.

Results: Of 244 patients enrolled, STI and ISR were observed in 11 (4.5%) and 10 (4.1%) patients, respectively. In multivariable analysis, higher white blood cell count (hazard ratio [HR], 1.408 per 10/mm; 95% confidence interval [CI], 1.085-1.828; =0.010), higher LDL-C levels after 12 months (HR, 1.037 per 1 mg/dL; 95% CI, 1.011-1.063; =0.005), and ISR (HR, 13.526; 95% CI, 3.405-53.725; <0.001) were independent predictors of STI. Diabetes (HR, 4.746; 95% CI, 1.026-21.948; =0.046), smaller stent diameter (HR, 0.725 per 1 mm; 95% CI, 0.537-0.980; =0.036), and higher LDL-C levels after 12 months (HR, 1.031 per 1 mg/dL; 95% CI, 1.007-1.055; =0.011) were independent predictors of ISR.

Conclusion: We showed that LDL-C levels after 12 months independently predict STI and ISR after CAS. It is necessary to investigate the optimal target LDL-C level for STI prevention through well designed research in the future.

Citing Articles

Risk factors of in-stent restenosis after carotid angioplasty and stenting: long-term follow-up study.

Park S, Kim B, Choi H, Chang D, Woo H, Heo S Front Neurol. 2024; 15:1411045.

PMID: 39175764 PMC: 11340531. DOI: 10.3389/fneur.2024.1411045.

Dyslipidemia Treatment and Cerebrovascular Disease: Evidence Regarding the Mechanism of Stroke.

Ha S, Kim B J Lipid Atheroscler. 2024; 13(2):139-154.

PMID: 38826180 PMC: 11140251. DOI: 10.12997/jla.2024.13.2.139.

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