Association of Lp-PLA
            <sub>2</sub>
            -A and early recurrence of vascular events after TIA and minor stroke

Lin, Jinxi; Zheng, Hongwei; Cucchiara, Brett; Li, Jiejie; Zhao, Xingquan; Liang, Xiaohu; Wang, Chunxue; Li, Hao; Mullen, Michael T.; Johnston, S. Claiborne; Wang, Yilong

doi:10.1212/wnl.0000000000001938

Cited by 50 publications

(41 citation statements)

References 22 publications

(21 reference statements)

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“…Recently, in the Clopidogrel in High-Risk Patients with Acute Non-disabling Cerebrovascular Events trial, Chinese patients, who experienced a transient ischemic attack or minor stroke, exhibited a positive association between increased Lp-PLA 2 levels and the short-term risk of ischemic events [9]. In addition, Lp-PLA 2 activity might be a useful tool for identifying patients with intracranial large-artery occlusive disease who are at higher risk of suffering new vascular events [13].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the individual roles of endothelial dysfunction and inflammation in intracranial atherosclerotic stroke (ICAS) remain unknown. Most previous studies reported an association between endothelial dysfunction or inflammation and clinical events, including stroke recurrence, in stroke patients; however, there have been few reports concerning patients with ICAS [6,7,8,9]. …”

Section: Introductionmentioning

confidence: 99%

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Distinct Roles of Endothelial Dysfunction and Inflammation in Intracranial Atherosclerotic Stroke

Chung

Oh²,

Cho³

et al. 2017

Eur Neurol

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Background/Aims: The aim of the study was to evaluate the differential roles of endothelial dysfunction and inflammation in intracranial atherosclerotic stroke (ICAS). Methods: We prospectively recruited 262 patients with acute cerebral infarcts caused by ICAS and 75 individuals with no history of stroke as controls. Markers of endothelial dysfunction (asymmetric dimethylarginine, ADMA) and inflammation (lipoprotein-associated phospholipase A2, Lp-PLA₂) were measured. Acute ischemic lesions were measured in terms of their size, composition, and patterns. Subclinical microangiopathy (degree of leukoaraiosis) and macroangiopathy (presence/number of asymptomatic stenoses) were graded in each patient. Results: Compared to normal controls, serum levels of ADMA (0.69 ± 0.14 vs. 0.47 ± 0.10, p < 0.001) and Lp-PLA₂ (138.1 ± 116.8 vs. 19.0 ± 58.0, p < 0.001) were elevated in patients with ICAS. A high ADMA serum level was associated with greater prevalence of preclinical microangiopathy and macroangiopathy. Contrastingly, an elevated serum Lp-PLA₂ level was associated with larger ischemic lesions, a greater number of lesions, and a larger cortical pattern. Conclusions: Endothelial dysfunction and inflammation have distinct effects in ICAS patents; endothelial dysfunction is associated with the underlying micro- and macro-atherosclerotic burden, whereas inflammation is associated with acute infarct volume and pattern.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Distinct Roles of Endothelial Dysfunction and Inflammation in Intracranial Atherosclerotic Stroke

Chung

Oh²,

Cho³

et al. 2017

Eur Neurol

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“…These findings strongly support that Lp-PLA2 plays important roles in the pathophysiological and clinical manifestations of cerebrovascular diseases. [1819] This paper revealed, from performing logistic regression analysis toward the 8 risk factors in 88 cases of ischemic cerebrovascular events, 4 significant independent risk factors toward stroke in EH patients, among which Lp-PLA2 is the most important independent risk factor ( OR : 13.699, 95% CI : 5.236–35.837, P < 0.0001), with B ’ as 0.708, indicating its highest risk toward stroke. The occurrence of stroke in EH patients with Lp-PLA2 ≥358.33 μg/L was 13.6 times than those with Lp-PLA2 < 358.33 μg/L, indicating that Lp-PLA2 is an important independent risk factor toward ischemic cerebrovascular events.…”

Section: Discussionmentioning

confidence: 94%

Relationships of Inflammatory Factors and Risk Factors with Different Target Organ Damage in Essential Hypertension Patients

Lai

Xing

Liu

et al. 2017

Chinese Medical Journal

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Background:Atherosclerosis (AS) is an inflammatory disease. Inflammation was considered to play a role in the whole process of AS. This study aimed to analyze the relationships of inflammatory factors and risk factors with different target organ damages (TOD) in essential hypertension (EH) patients and to explore its clinical significance.Methods:A total of 294 EH patients were selected and divided into four groups according to their conditions of TOD. Forty-eight healthy subjects were selected as control. The clinical biochemical parameters, serum amyloid A, serum tryptase, and lipoprotein-associated phospholipase A2 (Lp-PLA2) in each group were detected, and the related risk factors were also statistically analyzed.Results:Fibrinogen (Fbg) was the most significant independent risk factor in acute coronary syndrome (ACS) group (odds ratio [OR]: 22.242, 95% confidence interval [CI]: 6.458–76.609, P < 0.001) with the largest absolute value of the standardized partial regression coefficient B’ (b’: 1.079). Lp-PLA2 was the most significant independent risk factor in stroke group (OR: 13.699, 95% CI: 5.236–35.837, P < 0.001) with b’ = 0.708. Uric acid (UA) was the most significant independent risk factor in renal damage group (OR: 15.307, 95% CI: 4.022–58.250, P < 0.001) with b’ = 1.026.Conclusions:Fbg, Lp-PLA2, and UA are the strongest independent risk factors toward the occurrence of ACS, ischemic stroke, and renal damage in EH patients, thus exhibiting the greatest impacts on the occurrence of ACS, ischemic stroke, and renal damage in EH patients, respectively.

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“…29 Furthermore, the results of the investigation of large clinical samples show that higher levels of Lp-PLA2 in the acute period are associated with increased short-term risk of recurrent vascular events. 30 To our knowledge, atherosclerosis is a chronic inflammation associated with increased expression of the acute-phase isoforms of SAA. SAA is a plasma biomarker for future cardiovascular events.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of lipoprotein‐associated phospholipase A2, serum amyloid A, and fibrinogen as diagnostic biomarkers for patients with acute cerebral infarction

Liang

ShiChuan

De-tai

et al. 2019

Clinical Laboratory Analysis

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Objective The aim of this study was to explore the clinical values of combined detection of lipoprotein‐associated phospholipase A2 (Lp‐PLA2), serum amyloid A (SAA), and plasma fibrinogen (FIB) in the diagnosis of acute cerebral infarction (ACI). Methods A case‐control study including 100 hospitalized patients with ACI and 47 healthy controls was carried out. The level of Lp‐PLA2, SAA, and FIB was detected, respectively, and their clinical values were analyzed. Carotid lesions and neurological impairment were also analyzed in each patient. Results The level of Lp‐PLA2, SAA, and FIB in the ACI group was significantly higher than that of the controls, and the three biomarkers showed a significant positive correlation and were considered as risk factors for ACI. The area under the curve (AUC) for Lp‐PLA2, SAA, and FIB was 0.858, 0.743, and 0.672, respectively. When three biomarkers were used in combination, the AUC was 0.879. Compared with the other groups, the levels of three biomarkers in bilateral carotid plaque ACI group were all significantly higher. In addition, the level of Lp‐PLA2 and SAA in ACI patients with severe neurological impairment was also significantly higher than that of the mild‐to‐moderate group. Conclusion Lp‐PLA2 combined with SAA and FIB had a high clinical value for rapid diagnosis and prediction of ACI. These biomarkers were also significantly associated with the formation of bilateral carotid atherosclerotic plaques and the severe neurological impairment in ACI patients.

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Association of Lp-PLA ₂ -A and early recurrence of vascular events after TIA and minor stroke

Abstract: Higher levels of Lp-PLA2-A in the acute period are associated with increased short-term risk of recurrent vascular events.

Cited by 50 publications

References 22 publications

Distinct Roles of Endothelial Dysfunction and Inflammation in Intracranial Atherosclerotic Stroke

Distinct Roles of Endothelial Dysfunction and Inflammation in Intracranial Atherosclerotic Stroke

Relationships of Inflammatory Factors and Risk Factors with Different Target Organ Damage in Essential Hypertension Patients

Evaluation of lipoprotein‐associated phospholipase A2, serum amyloid A, and fibrinogen as diagnostic biomarkers for patients with acute cerebral infarction

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Association of Lp-PLA 2 -A and early recurrence of vascular events after TIA and minor stroke

Abstract: Higher levels of Lp-PLA2-A in the acute period are associated with increased short-term risk of recurrent vascular events.

Cited by 50 publications

References 22 publications

Distinct Roles of Endothelial Dysfunction and Inflammation in Intracranial Atherosclerotic Stroke

Distinct Roles of Endothelial Dysfunction and Inflammation in Intracranial Atherosclerotic Stroke

Relationships of Inflammatory Factors and Risk Factors with Different Target Organ Damage in Essential Hypertension Patients

Evaluation of lipoprotein‐associated phospholipase A2, serum amyloid A, and fibrinogen as diagnostic biomarkers for patients with acute cerebral infarction

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Association of Lp-PLA ₂ -A and early recurrence of vascular events after TIA and minor stroke