Lipoprotein-associated phospholipase-A 2 activity and its diagnostic potential in patients with acute coronary syndrome and acute ischemic stroke

Abstract

BackgroundThe study examined the Lp-PLA2 activity at the patients presented to the emergency department with acute coronary syndrome (ACS) or acute ischemic stroke (AIS), as well as its diagnostic value.MethodsThe prospective study included consecutive male and female patients aged >18 years that presented to the our emergency department with ACS or AIS between November 2009 and January 2010. Blood samples were obtained immediately following diagnosis in the ACS and AIS groups. The diagnostic value of Lp-PLA2 was determined based on receiver operating characteristic curves, sensitivity, specificity, predictive values, likelihood ratios and accuracy rates.ResultsIn all, 34 ACS and 32 AIS patients were included in the study, and the control group included 35 patients. Lp-PLA2 enzyme activity was significantly lower in the ACS and AIS groups than in the control group (26.7 ± 13.8, 31.4 ± 13.6, and 41.4 ± 8.1 nmol min−1·mL−1, respectively; p < 0.0001, p = 0.022). In the ACS group the area under the curve (AUC) was 0.825 (95%CI: 0.722–0.929), sensitivity was 71% for an optimal Lp-PLA2 cut-off value of 31.4 nmol min−1·mL−1, and specificity was 91%, whereas in the AIS group the AUC was 0.768 (95%CI: 0.652–0.884), sensitivity was 75% for an optimal Lp-PLA2 cut-off value of 38.1 nmol min−1·mL−1, and specificity was 74%.ConclusionsLp-PLA2 enzyme activity was significantly lower during the early stage of both ACS and AIS. The obtained statistic data suggest that low Lp-PLA2 enzyme activity can be used for diagnostic purposes.

Change in lipoprotein-associated phospholipase A2 and its association with cardiovascular outcomes in patients with acute coronary syndrome

“…We noticed that serum Lp-PLA2 level decreased gradually in higher Lp-PLA2 group, while Lp-PLA2 showed an increase at first and then decrease in lower Lp-PLA2 group. Contrarily, Kocak et al [ 18 ] reported that Lp-PLA2 enzyme activity was lower in patients with ACS than in control group. Secondly, the time window for blood sample collection was different.…”

“…Serum Lp-PLA2 mass or activity was measured in different studies. [ 6 , 18 , 23 , 26 ] The standardization of assay calibration needs to be setup.…”

“…[ 16 , 17 ] By contrast, Kocak et al found that Lp-PLA2 enzyme activity was significantly lower during the early stage of ACS. [ 18 ]…”

Measuring lipoprotein‐associated phospholipase A2 activity in China: Protocol comparison and recalibration

“…During clinical evaluation, method‐specific reference intervals are also problematic, particularly for patients who visit different hospitals and/or are seen by different doctors. Furthermore, although measuring Lp‐PLA2 activity can help provide guidance for early disease care and prevention, it can only be used as a reliable risk factor if is monitored accurately and consistently. It is also important to note that there is currently no published reference medical decision level that can be used as an indicator for CVD or stroke.…”

“…Therefore, numerous studies have identified and evaluated independent biomarkers, many of which are inflammatory factors, to predict the risk factors of CVD and stroke. Lipoprotein‐associated phospholipase A2 (Lp‐PLA2), for example, is a vascular inflammatory factor that has been demonstrated to be pro‐atherosclerosis and positively correlated with CVD and ischemic stroke . These clinical studies indicate Lp‐PLA2 as an independent risk factor for these inflammation‐related conditions.…”