Abstract
Background: Plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) has emerged as a novel biomarker for coronary atherosclerosis. However, the association between Lp-PLA2 and plaque vulnerability in atherosclerosis of cervicocerebral arteries remains poorly defined, especially for intracranial atherosclerotic stenosis (ICAS). We aimed to investigate the association between Lp-PLA2 and plaque vulnerability in transient ischemic attack (TIA) patients with unilateral middle cerebral artery stenoses (MCAs).Methods: In this study, a total of 207 patients were enrolled from April 2017 to April 2020. Clinical data were collected, and MCA plaques were examined with high-resolution magnetic resonance imaging (HRMRI). Baseline characteristics of patients were collected during hospitalization. Statistical comparisons were performed using Pearson's chi-squared test, Mann–Whitney U test, and the Breslow–Day/Tarone's test for the determination of heterogeneity in different age strata. Multivariate binary logistic analysis was used to investigate the potential independent predictors that were highly correlated to plaque vulnerability.Results: The results showed that a high Lp-PLA2 level (>221 ng/ml) was associated with plaque vulnerability in TIA patients with unilateral MCAs. High Lp-PLA2 was independently associated with plaque vulnerability in patients ≤ 60 years old [multivariate adjusted odds ratio (OR) = 9.854; 95% CI, 2.458–39.501] but not in patients >60 years old (multivariate adjusted OR = 1.901; 95% CI, 0.640–5.650). Predictors of plaque vulnerability in different age strata were also different.Conclusion: Lp-PLA2 levels may be correlated to plaque vulnerability in TIA patients with unilateral MCAs and might be a diagnostic biomarker for plaque vulnerability in this kind of patients, especially for ones aged ≤ 60 years old.
Highlights
Atherosclerosis (AS) is a kind of chronic inflammatory disease developed by heterogeneous causes [1]
The levels of high-density lipoproteins (HDLs), apolipoprotein B (APOB), and lipoprotein-associated phospholipase A2 (Lp-PLA2) were statistically different between patients with vulnerable and nonvulnerable plaque (Mann–Whitney test, p-values were 0.005, 0.030,
High Lp-PLA2 was associated with plaque vulnerability statistically (OR = 2.956; 95% cerebral infarction (CI), 1.616–5.407)
Summary
Atherosclerosis (AS) is a kind of chronic inflammatory disease developed by heterogeneous causes [1]. Plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) has emerged as a novel inflammatory biomarker, which is involved in the initiation and progression of AS [2] It is widely used as an inflammation predictor of atherosclerotic plaque in recent years [3]. For the last few years, high-resolution magnetic resonance imaging (HRMRI) was applied as a crucial noninvasive technique for the clinical determination of ICAS It can objectively exhibit intracranial arterial wall morphology and atherosclerosis plaque characteristics by obtaining morphological measurements for atherosclerosis plaque composition [7, 8]. We aimed to investigate the association between Lp-PLA2 and plaque vulnerability in transient ischemic attack (TIA) patients with middle cerebral artery stenoses (MCAs) and explored whether Lp-PLA2 could be a potential diagnostic biomarker for plaque vulnerability in intracranial atherosclerotic artery. We aimed to investigate the association between Lp-PLA2 and plaque vulnerability in transient ischemic attack (TIA) patients with unilateral middle cerebral artery stenoses (MCAs)
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