Lipoprotein-associated phospholipase A₂ is related to plaque stability and is a potential biomarker for acute coronary syndrome

• Published in: Yonsei medical journal Vol. 55; no. 6; pp. 1507 - 1515
• Main Authors: Chung, Hyemoon, Kwon, Hyuck Moon, Kim, Jong-Youn, Yoon, Young-Won, Rhee, Jihyuk, Choi, Eui-Young, Min, Pil-Ki, Hong, Bum-Kee, Rim, Se-Joong, Yoon, Ji Hyun, Lee, Sung-Joo, Park, Jong-Kwan, Kim, Myung-Hyun, Jo, Minhee, Yang, Jeong-Hee, Lee, Byoung Kwon
• Format: Journal Article
• Language: English
• Published: Korea (South) Yonsei University College of Medicine 01.11.2014; 연세대학교의과대학
• Subjects: 1-Alkyl-2-acetylglycerophosphocholine Esterase - blood; Acute Coronary Syndrome - blood; Acute Coronary Syndrome - physiopathology; Aged; Aged, 80 and over; Angina Pectoris; Biomarkers - blood; C-Reactive Protein - metabolism; Coronary Angiography; Female; Humans; Lipoproteins, LDL - blood; Logistic Models; Male; Middle Aged; Multivariate Analysis; Original; Plaque, Atherosclerotic - blood; Risk Factors; ROC Curve; 의학일반; coronary atherosclerotic plaque instability; acute coronary syndrome; Lp-PLA; biomarker
• ISSN: 1976-2437; 0513-5796; 1976-2437
• DOI: 10.3349/ymj.2014.55.6.1507

Plasma lipoprotein-associated phospholipase A₂ (Lp-PLA₂) binds to low-density lipoprotein. The levels of Lp-PLA₂ reflect the plaque burden, and are upregulated in acute coronary syndrome (ACS). We investigated the diagnostic value of Lp-PLA2 levels and found that it might be a potential biomarker for ACS. We classified 226 study participants into three groups: patients without significant stenosis (control group), patients with significant stenosis with stable angina (SA group), and patients with ACS (ACS group). Lp-PLA₂ and high-sensitivity C-reactive protein (hs-CRP) levels were significantly greater in the ACS group than in the SA group (p=0.044 and p=0.029, respectively). Multivariate logistic regression analysis revealed that Lp-PLA₂ levels are significantly associated with ACS (odds ratio=1.047, p=0.013). The addition of Lp-PLA₂ to the ACS model significantly increased the global χ² value over traditional risk factors (28.14 to 35.602, p=0.006). The area under the receiver operating characteristic curve for Lp-PLA₂ was 0.624 (p=0.004). The addition of Lp-PLA₂ level to serum hs-CRP concentration yielded an integrated discrimination improvement of 0.0368 (p=0.0093, standard error: 0.0142) and improved the ability to diagnose ACS. Lp-PLA₂ levels are related to plaque stability and might be a diagnostic biomarker for ACS.