Nonfasting Triglyceride as an Independent Predictor of Carotid Restenosis After Carotid Endarterectomy or Carotid Artery Stenting
Nonfasting Triglyceride as an Independent Predictor of Carotid Restenosis After Carotid Endarterectomy or Carotid Artery Stenting
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DOI：
10.1016/j.wneu.2021.09.091
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发表时间：
2021-11-18
影响因子：
2
通讯作者：
Suzuki, Hidenori
中科院分区：
文献类型：
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作者：
Miura, Yoichi;Kanamaru, Hideki;Suzuki, Hidenori
目的：非空腹血清甘油三酯(TG)水平作为动脉粥样硬化的促进因素正受到越来越多的关注。然而，还没有研究探讨非空腹甘油三酯水平与颈动脉内膜切除术(CEA)或颈动脉支架置入术(CAS)后颈动脉再狭窄的关系。本研究旨在探讨非空腹甘油三酯水平是否可用于评估颈动脉CEA或CAS术后再狭窄的风险。方法：本研究为单中心回顾性研究。我们回顾了2008年至2018年连续201例初次颈动脉血运重建术(39例CEA和162例CASS)，其中179例(男性163例，女性16例)接受了动脉粥样硬化性颈动脉狭窄，并进行了至少1年的随访。比较术后颈动脉再狭窄组与无再狭窄组的临床指标，包括非空腹血脂谱和磁共振斑块成像表现。结果：在平均1413天的随访期内，在201例颈动脉狭窄手术中，24例(11.9%)在成功的血管重建术后发生了再狭窄。多因素分析显示，非空腹甘油三酯水平是术后再狭窄的唯一独立危险因素。受试者操作特征曲线分析显示，非空腹TG判别术后颈动脉再狭窄的临界值为127.5 mg/dL，远低于正常上限。结论：非空腹甘油三酯水平可作为预测CEA或CAS术后颈动脉再狭窄的有用指标，可作为预防颈动脉血运重建术后再狭窄的新的治疗靶点。
OBJECTIVE: Nonfasting serum triglyceride (TG) level is attracting more and more attention as an atherosclerosis-promoting factor. However, no study has investigated the relationships between nonfasting TG levels and carotid restenosis after carotid endarterectomy (CEA) or carotid artery stenting (CAS). This study was conducted to inves-tigate if nonfasting TG levels can be used to assess a risk for carotid restenosis after CEA or CAS. - METHODS: This was a single-center retrospective study. We reviewed 201 consecutive primary carotid artery revascularization procedures (39 CEAs and 162 CASs), which were performed from 2008 to 2018 for 179 patients (163 men and 16 women) with atherosclerotic carotid ste-nosis, and were followed up for at least 1 year. Clinical variables including nonfasting lipid profiles and findings of magnetic resonance plaque imaging were compared be-tween groups with and without postprocedural carotid restenosis (double dagger 50% stenosis on ultrasonography). -RESULTS: During a mean follow-up period of 1413 days, 24 of 201 carotid stenosis procedures (11.9%) suffered restenosis after successful revascularization procedures. Multivariate analyses demonstrated that nonfasting TG level was the only independent risk factor of post-procedural restenosis. The receiver operating character-istic curve analyses revealed that a cutoff value of nonfasting TG to discriminate postprocedural carotid restenosis was 127.5 mg/dL, which was much lower than the upper limit of normal. -CONCLUSIONS: This study showed that nonfasting TG level may be a useful marker to predict carotid restenosis after CEA or CAS, and could be a new therapeutic target to prevent carotid restenosis after revascularization procedures.