Abstract
The aim of this study is to evaluate serum level biomarkers of atherosclerosis lipoprotein-associated phospholipase A2 and E-selectin in patients with atherosclerotic carotid stenosis with different clinical manifestation in associated with vascular risk factors.
 Materials and methods: A total 106 patients with atherosclerotic carotid stenosis (74 men and 32 women, aged from 31 to 74 years, mean 62.6±0.9) were included: with acute ipsilateral atherothrombotic stroke (35), history of stroke and carotid endarterectomy (41) and 30 patients with asymptomatic carotid stenosis. The control group consist of 20 health subjects without cardiovascular disease. All participants underwent duplex sonography. Lipoprotein-associated phospholipase A2 and E-selectin was measured using commercially available (ELISA) kit.
 Results: The level of lipoprotein-associated phospholipase A2 was in general 55.664±3.537 ng/ml, which was significantly higher (M-W U=10, p=1.023136´10-11 <0.05) than in the control group (9.296±0.935 ng/ml). Level was significantly higher in groups of symptomatic patients who underwent carotid endarterectomy (p=0.04893), and proportion patients with high degree stenosis >70 % was greater in this group. The level of E-selectin in the study patients was significantly higher (7.653±0.246 pg/ml) than in the control group (3.101±0.503 pg/ml) p<0.05. No association the serum level of lipoprotein-associated phospholipase A2 and E-selectin with common stroke risk factor such as hypercholesterinemia, smoking and body mass index were found, but positive correlation of lipoprotein-associated phospholipase A2 with E-selectin was significant (p=0.00085).
 Conclusions: Increasing plasma level lipoprotein-associated phospholipase A2 and E-selectin in patients with the carotid atherosclerotic stenosis were observe. Statistically significant correlation between the level of lipoprotein-associated phospholipase A2 and E-selectin were found in symptomatic carotid atherosclerotic stenosis
Highlights
Carotid atherosclerosis is the cause of 20-25 % of all cerebral strokes, one of the main causes of chronic disorders of cerebral circulation, but it could be clinically "silent" [1]
The aim of this study is to evaluate serum level biomarkers of atherosclerosis lipoprotein-associated phospholipase A2 (Lp-PLA2) and E-selectin in patients with atherosclerotic carotid stenosis with different clinical manifestation in associated with vascular risk factors
The proportion of women with stenosis from 50 % to 69 % significantly exceeds the proportion of men with a similar degree of stenosis (Z=2.748, p=0.00300,
Summary
Carotid atherosclerosis is the cause of 20-25 % of all cerebral strokes, one of the main causes of chronic disorders of cerebral circulation, but it could be clinically "silent" [1]. The degree of stenosis alone is not sufficient to decide upon the best clinical management in some situations. In this context, it is essential to further characterize plaque vulnerability, according to specific characteristics (lipid-rich core, fibrous cap thinning, intraplaque hemorrhage). It is essential to further characterize plaque vulnerability, according to specific characteristics (lipid-rich core, fibrous cap thinning, intraplaque hemorrhage) These features could be partly detected by imaging techniques, identifying carotid plaque vulnerability is still challenging. Inflammatory activity plays a key role in the pathogenesis, progression, rupture of atherosclerotic plaque and the development of clinical manifestations in patients with atherosclerotic carotid stenosis [4]. One of the markers of inflammatory activity in atherosclerosis is lipoprotein-associated phospholipase A2 (Lp-PLA2), which may be involved in the process of destabilizing atherosclerotic plaques by increasing inflammatory activity in atherosclerotic foci [5]
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