Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012;7(10):e48171.
doi: 10.1371/journal.pone.0048171. Epub 2012 Oct 31.

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

Giuseppe Maiolino  1 , Luigi Pedon, Maurizio Cesari, Anna Chiara Frigo, Robert L Wolfert, Marlena Barisa, Leopoldo Pagliani, Giacomo Rossitto, Teresa Maria Seccia, Mario Zanchetta, Gian Paolo Rossi
Affiliations

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

Giuseppe Maiolino et al. PLoS One. 2012.

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.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Data analysis flow chart.
The flow chart shows the selection process by which the patients were submitted to statistical analysis.
Figure 2
Figure 2. Cardiovascular events by Lp-PLA2 mass.
The bar graphs show cardiovascular death and events rate by quartiles of Lp-PLA2 mass (the absolute number of events is shown above each column). Cardiovascular deaths (p = 0.020) were significantly different across Lp-PLA2 mass quartiles. AMI: acute myocardial infarction.
Figure 3
Figure 3. Cardiovascular events by Lp-PLA2 activity.
The bar graphs show cardiovascular death and events rate by quartiles of Lp-PLA2 activity (the absolute number of events is shown above each column). Cardiovascular deaths (p = 0.012), events (p = 0.016), acute myocardial infarction (AMI) (p = 0.019) were significantly different across Lp-PLA2 activity quartiles.
Figure 4
Figure 4. Cardiovascular events- and acute coronary syndromes-free survival.
Kaplan-Meier curves show cardiovascular (CV) events- (left Panel) and acute coronary syndromes (ACS)-free survival (right Panel) in the propensity score-matched high-risk patients divided into the high and low Lp-PLA2 activity group. Patients with high Lp-PLA2 activity had a significantly lower CV events-free survival and a significantly lower ACS-free survival.
See this image and copyright information in PMC

References

    1. Asano K, Okamoto S, Fukunaga K, Shiomi T, Mori T, et al. (1999) Cellular source(s) of platelet-activating-factor acetylhydrolase activity in plasma. Biochemical and Biophysical Research Communications 261: 511–514. - PubMed
    1. Burke JE, Dennis EA (2009) Phospholipase A2 biochemistry. Cardiovascular Drugs and Therapy/Sponsored by the International Society of Cardiovascular Pharmacotherapy 23: 49–59. - PMC - PubMed
    1. Gaubatz JW, Gillard BK, Massey JB, Hoogeveen RC, Huang M, et al. (2007) Dynamics of dense electronegative low density lipoproteins and their preferential association with lipoprotein phospholipase A(2). Journal of Lipid Research 48: 348–357. - PubMed
    1. Stafforini DM, McIntyre TM, Carter ME, Prescott SM (1987) Human plasma platelet-activating factor acetylhydrolase. association with lipoprotein particles and role in the degradation of platelet-activating factor. The Journal of Biological Chemistry 262: 4215–4222. - PubMed
    1. Hakkinen T, Luoma JS, Hiltunen MO, Macphee CH, Milliner KJ, et al. (1999) Lipoprotein-associated phospholipase A(2), platelet-activating factor acetylhydrolase, is expressed by macrophages in human and rabbit atherosclerotic lesions. Arteriosclerosis, Thrombosis, and Vascular Biology 19: 2909–2917. - PubMed

Publication types

MeSH terms