Active Smoking, Not Mean Platelet Volume, Found to Be Risk Factor for Carotid In-Stent Restenosis

Mean platelet volume (MPV) was not found to represent a risk factor for in-stent restenosis (ISR) after carotid artery stenting in white individuals, according to a study published in Stroke.

In this retrospective study, 392 white patients (mean age, 68.5±9.5 years; ISR, 96.4%) who underwent carotid artery stenting for atherosclerotic disease, were included. All procedures were performed at a single center between 2005 and 2017. Follow-up clinical visits and duplex ultrasonography were undertaken at months 1, 3, and 6, and annually after the stenting procedure. Based on criteria established by the North American Symptomatic Carotid Endarterectomy Trial (NASCET), the presence of ISR was defined as ≥50% stenosis in the treated vessel. Blood parameters were examined at the time of ISR detection and at final follow-up.

During a mean follow up of 60 months (range, 3-165 months), 54 participants (13.8%) presented with ISR within a mean of 32 months (range, 1-135 months), and 6 of these patients had symptomatic ISR. Baseline MPV levels were comparable in patients with and without ISR (10.7 vs 10.6 fL, respectively; P =.316), and from baseline to detection of ISR (P =.310) or to the final clinical follow-up (P =.710). In addition, MPV levels were not associated with recurrent stroke (P =.811) or vascular events (P =.651). Active smoking was the only independent risk factor for carotid ISR identified (odds ratio, 2.53; 95% CI, 1.21-5.29; P =.013).

Study limitations include its small sample size, retrospective design, and the lack of documentation of certain laboratory variables at baseline and follow-up sessions.

“In this large retrospective study on consecutive patients receiving CAS for atherosclerotic stenosis, we did not find an association between elevated MPV and ISR,” Concluded the study authors.

Disclosure: One study author declared affiliations with biotech companies. Please see the original reference for a full list of authors’ disclosures.

Reference

Haidegger M, Kneihsl M, Niederkorn K, et al. Mean platelet volume does not predict restenosis after carotid artery stenting in whites [published online December 18, 2019]. Stroke. doi: 10.1161/STROKEAHA.119.028180