Seung Min Kim, Jae Chan Ryu, Sujin Koo, Jong S Kim, Bum Joon Kim
{"title":"低密度脂蛋白胆固醇水平与颈动脉支架植入术后支架区缺血性卒中相关:一项单中心回顾性研究","authors":"Seung Min Kim, Jae Chan Ryu, Sujin Koo, Jong S Kim, Bum Joon Kim","doi":"10.12997/jla.2023.12.2.175","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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<sup>3</sup>/mm<sup>3</sup>; 95% confidence interval [CI], 1.085-1.828; <i>p</i>=0.010), higher LDL-C levels after 12 months (HR, 1.037 per 1 mg/dL; 95% CI, 1.011-1.063; <i>p</i>=0.005), and ISR (HR, 13.526; 95% CI, 3.405-53.725; <i>p</i><0.001) were independent predictors of STI. Diabetes (HR, 4.746; 95% CI, 1.026-21.948; <i>p</i>=0.046), smaller stent diameter (HR, 0.725 per 1 mm; 95% CI, 0.537-0.980; <i>p</i>=0.036), and higher LDL-C levels after 12 months (HR, 1.031 per 1 mg/dL; 95% CI, 1.007-1.055; <i>p</i>=0.011) were independent predictors of ISR.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":16284,"journal":{"name":"Journal of Lipid and Atherosclerosis","volume":"12 2","pages":"175-188"},"PeriodicalIF":0.0000,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3b/ca/jla-12-175.PMC10232219.pdf","citationCount":"0","resultStr":"{\"title\":\"Low-Density Lipoprotein Cholesterol Levels Are Associated With Subsequent Stented-Territory Ischemic Stroke After Carotid Artery Stenting: A Single Center Retrospective Study.\",\"authors\":\"Seung Min Kim, Jae Chan Ryu, Sujin Koo, Jong S Kim, Bum Joon Kim\",\"doi\":\"10.12997/jla.2023.12.2.175\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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<sup>3</sup>/mm<sup>3</sup>; 95% confidence interval [CI], 1.085-1.828; <i>p</i>=0.010), higher LDL-C levels after 12 months (HR, 1.037 per 1 mg/dL; 95% CI, 1.011-1.063; <i>p</i>=0.005), and ISR (HR, 13.526; 95% CI, 3.405-53.725; <i>p</i><0.001) were independent predictors of STI. Diabetes (HR, 4.746; 95% CI, 1.026-21.948; <i>p</i>=0.046), smaller stent diameter (HR, 0.725 per 1 mm; 95% CI, 0.537-0.980; <i>p</i>=0.036), and higher LDL-C levels after 12 months (HR, 1.031 per 1 mg/dL; 95% CI, 1.007-1.055; <i>p</i>=0.011) were independent predictors of ISR.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":16284,\"journal\":{\"name\":\"Journal of Lipid and Atherosclerosis\",\"volume\":\"12 2\",\"pages\":\"175-188\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3b/ca/jla-12-175.PMC10232219.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Lipid and Atherosclerosis\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.12997/jla.2023.12.2.175\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Lipid and Atherosclerosis","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.12997/jla.2023.12.2.175","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
Low-Density Lipoprotein Cholesterol Levels Are Associated With Subsequent Stented-Territory Ischemic Stroke After Carotid Artery Stenting: A Single Center Retrospective Study.
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 103/mm3; 95% confidence interval [CI], 1.085-1.828; p=0.010), higher LDL-C levels after 12 months (HR, 1.037 per 1 mg/dL; 95% CI, 1.011-1.063; p=0.005), and ISR (HR, 13.526; 95% CI, 3.405-53.725; p<0.001) were independent predictors of STI. Diabetes (HR, 4.746; 95% CI, 1.026-21.948; p=0.046), smaller stent diameter (HR, 0.725 per 1 mm; 95% CI, 0.537-0.980; p=0.036), and higher LDL-C levels after 12 months (HR, 1.031 per 1 mg/dL; 95% CI, 1.007-1.055; p=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.
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