Lipoprotein-associated phospholipase A2 activity predicts cardiovascular events in high risk coronary artery disease patients.

Abstract

OBJECTIVE:

Lipoprotein-associated phospholipase A2 (Lp-PLA2) is deemed to play a role in atherosclerosis and plaque destabilization as demonstrated in animal models and in prospective clinical studies. However, most of the literature is either focused on high-risk, apparently healthy patients, or is based on cross sectional studies. Therefore, we tested the hypothesis that serum Lp-PLA2 mass and activity are useful for predicting cardiovascular (CV) events over the coronary atherosclerotic burden and conventional risk factors in high-risk coronary artery disease patients.

METHODS AND RESULTS:

In a prospective cohort study of 712 Caucasian patients, who underwent coronary angiography and measurement of both Lp-PLA2 mass and activity at baseline, we determined incident CV events at follow-up after splitting the patients into a high and a low Lp-PLA2 mass and activity groups based on ROC analysis and Youden index. Kaplan-Meier and propensity score matching analysis were used to compare CV event-free survival between groups. Follow-up data were obtained in 75% of the cohort after a median of 7.2 years (range 1-12.7 years) during which 129 (25.5%) CV events were observed. The high Lp-PLA2 activity patients showed worse CV event-free survival (66.7% vs. 79.5%, p = 0.023) and acute coronary syndrome-free survival (75.4% vs. 85.6%, p = 0.04) than those in low Lp-PLA2 group.

CONCLUSIONS:

A high Lp-PLA2 activity implies a worse CV prognosis at long term follow up in high-risk Caucasian patients referred for coronary angiography.

• Authors: Giuseppe Maiolino, Luigi Pedon, Maurizio Cesari, Anna Chiara Frigo, Robert L Wolfert, Marlena Barisa, Leopoldo Pagliani, Giacomo Rossitto, Teresa Maria Seccia, Mario Zanchetta, Gian Paolo Rossi
• Journal: PloS one (PLoS One) Vol. 7 Issue 10 Pg. e48171 ( 2012) ISSN: 1932-6203 [Electronic] United States
• PMID: 23118945 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Lipoproteins, HDL
• Lipoproteins, LDL
• Creatinine
• 1-Alkyl-2-acetylglycerophosphocholine Esterase

Topics

• 1-Alkyl-2-acetylglycerophosphocholine Esterase (blood, chemistry)
• Acute Coronary Syndrome (blood, diagnostic imaging, enzymology, mortality)
• Aged
• Coronary Artery Disease (blood, diagnostic imaging, enzymology, mortality)
• Creatinine (blood)
• Disease-Free Survival
• Follow-Up Studies
• Humans
• Kaplan-Meier Estimate
• Linear Models
• Lipoproteins, HDL (blood)
• Lipoproteins, LDL (blood)
• Male
• Middle Aged
• Molecular Weight
• Multivariate Analysis
• Prognosis
• Propensity Score
• Proportional Hazards Models
• Prospective Studies
• ROC Curve
• Radiography
• Risk Factors