Abstract
BackgroundLipoprotein-associated phospholipase A2 (Lp-PLA2) plays complex and adverse roles on atherosclerosis. Current study was to investigate whether increased plasma Lp-PLA2 level is independently associated with the severity of coronary artery diseases (CAD).MethodsTotally 781 participants were enrolled and performed coronary angiography (CAG) to figure out the number of coronary artery stenosis. According to clinical presentation, electrocardiography, cardiac biomarker, and CAG result, participants were divided into control (excluded CAD), stable angina (SA), unstable angina (UA) and acute myocardial infarction (AMI) groups. Baseline characteristics were recorded. Statistical analyses were performed to evaluate the relationship between Lp-PLA2 level and CAD severity.ResultsPlasma levels of Lp-PLA2 in control, SA, UA and AMI groups were 7.38(3.33-9.26) μg/L, 5.94(2.89-8.55) μg/L, 8.56(5.34-11.95) μg/L and 8.68(5.56-13.27) μg/L respectively (P < 0.001). After adjusted for age, gender, smoking, diabetes mellitus, hypertension, low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), apoprotein A (apoA) and statins, Lp-PLA2 level was still independently associated with CAD severity, with odd ratio (OR) of 1.055 (AMI group versus control group, 95% confidence interval (CI) 1.021-1.090, P < 0.05). Additionally, the relationship between Lp-PLA2 level and the number of stenosis coronary artery was also assessed. Lp-PLA2 levels in control, single-vessel, and multiple-vessels stenosis groups were 7.38(3.33-9.26) μg/L, 7.80 (4.05-10.76) μg/L and 8.29(5.18-11.76) μg/L respectively (P for trend < 0.001). After adjusted for age, gender, smoking, diabetes mellitus, hypertension, LDL-C and HDL-C, apoA and statins, Lp-PLA2 level remained independently associated with the number of coronary artery stenosis, with OR of 1.053 (multiple-vessels stenosis group versus control group, 95% CI 1.025-1.069, P < 0.05).ConclusionIncreased Lp-PLA2 level is independently associated with CAD severity, and Lp-PLA2 level may be used to discriminate those who are at increased risk of cardiovascular events.
Highlights
Lipoprotein-associated phospholipase A2 (Lp-PLA2) plays complex and adverse roles on atherosclerosis
Clinical epidemiological studies showed that increased plasma level of Lp-PLA2 was associated with increased risk of cardiovascular events such as myocardial infarction and ischemic stroke [7,8,9], and LpPLA2 inhibitors could significantly reduce the incident of cardiovascular events as compared to placebo treatment [10,11]
Studied subjects and protocols Studied subjects were enrolled from January of 2013 to April of 2014 after informed consent was obtained, and our current study was approved by the Ethical Committee of Guangdong General Hospital
Summary
Lipoprotein-associated phospholipase A2 (Lp-PLA2) plays complex and adverse roles on atherosclerosis. Current study was to investigate whether increased plasma Lp-PLA2 level is independently associated with the severity of coronary artery diseases (CAD). Clinical epidemiological studies showed that increased plasma level of Lp-PLA2 was associated with increased risk of cardiovascular events such as myocardial infarction and ischemic stroke [7,8,9], and LpPLA2 inhibitors could significantly reduce the incident of cardiovascular events as compared to placebo treatment [10,11]. Despite striking and encouraging findings from previous studies, two recent large randomized, controlled and prospective clinical trials showed that darapladib treatment, a selective Lp-PLA2 antagonist, resulted in no better improvement of clinical outcomes in patients with stable or unstable coronary artery diseases (CAD) [16,17]
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