Plasma PAF-acetylhydrolase in patients with coronary artery disease: results of a cross-sectional analysis.
Inflammation underlies both onset and perpetuation of atherosclerosis. Plasma lipoproteins transport the platelet-activating factor-acetylhydrolase (PAF-AH) with potentially anti-inflammatory activities. Our aim was to determine whether PAF-AH activity was associated with inflammatory markers and with coronary artery disease (CAD). PAF-AH activity and a panel of inflammatory mediators were measured in plasma of 496 patients with CAD and in 477 controls; 276 patients presented with stable angina pectoris and 220 with acute coronary syndrome (ACS). Individuals within the highest quartile of PAF-AH activity had an 1.8-fold increase in CAD risk [95% confidence interval (CI), 1.01 to 3.2; P = 0.048] compared with those in the first quartile (adjusted for clinical and metabolic factors). When excluding individuals receiving statin and angiotensin-converting enzyme-inhibitor medication, individuals within the highest quartile of PAF-AH activity revealed a 3.9-fold increase in CAD risk (95% CI, 2.0 to 7.7; P < 0.0001). In these subjects, the plasma PAF-AH activity increased gradually in stable angina and in ACS both in men (P < 0.0001) and in women (P < 0.001), as compared with controls. No correlation was found between PAF-AH levels and those of common markers of inflammation. This study and the previous ones raise the important issue of whether PAF-AH is simply a marker of risk or directly promotes atherosclerosis.
INSERM U525/IFR14, Coeur Muscle Vaisseaux and Université Pierre & Marie Curie, Faculté de Médecine Pitié-Salpétrière, Paris, France.
Stefan
S
Blankenberg
Dominique
D
Stengel
Hans J
HJ
Rupprecht
Christoph
C
Bickel
Jürgen
J
Meyer
François
F
Cambien
Laurence
L
Tiret
Ewa
E
Ninio
D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000097:blood*; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology; D003324:Coronary Artery Disease / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D020125:Mutation, Missense; D012306:Risk; D012307:Risk Factors; D012737:Sex Factors; D013577:Syndrome
D000806:Angiotensin-Converting Enzyme Inhibitors; D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase