title: Association between Lp-PLA2 and coronary artery disease: focus on its relationship with lipoproteins and markers of inflammation and hemostasis.
abstract: Lipoprotein-associated phospholipase A2 (Lp-PLA2) generates pro-inflammatory molecules from oxidized LDL. We examined the association between Lp-PLA2 plasma concentrations and risk of stable coronary artery disease (CAD) in a large case-control study and further assessed the relationship between Lp-PLA2 and various lipid, inflammatory and hemostatic parameters. Lp-PLA2 concentrations were measured in 312 patients with CAD and in 479 age- and gender-matched blood donors. Various sensitive inflammatory and hemostatic markers and a complete lipoprotein profile were obtained. Lp-PLA2 concentrations were significantly higher in cases than in controls (296.1 ng/mL versus 266.0 ng/mL, p<0.0001). In multivariable logistic regression, the age- and gender-adjusted OR for the presence of CAD was 1.61 (95% CI, 1.07-2.44) if the top quartile of the Lp-PLA2 distribution was compared to the bottom quartile. Adjustment for traditional cardiovascular risk factors and statin use resulted in an OR of 2.04 (95% CI, 1.19-3.48). After additional controlling for vWF, the OR was slightly attenuated but still remained statistically significant (OR 1.91; 95% CI, 1.12-3.28). Thus, elevated Lp-PLA2 concentrations were associated with the presence of stable CAD, independent of various biochemical markers. Our results support the hypothesis that Lp-PLA2 may be a novel, independent risk marker for CAD.
authors.affiliation: Department of Internal Medicine II, Cardiology, University of Ulm Medical Center, Robert-Koch Str. 8, D-89081 Ulm, Germany.
authors.forename: Natalie
authors.initials: N
authors.lastname: Khuseyinova
authors.forename: Armin
authors.initials: A
authors.lastname: Imhof
authors.forename: Dietrich
authors.initials: D
authors.lastname: Rothenbacher
authors.forename: Gerlinde
authors.initials: G
authors.lastname: Trischler
authors.forename: Silke
authors.initials: S
authors.lastname: Kuelb
authors.forename: Hubert
authors.initials: H
authors.lastname: Scharnagl
authors.forename: Winfried
authors.initials: W
authors.lastname: Maerz
authors.forename: Hermann
authors.initials: H
authors.lastname: Brenner
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Koenig
mesh_terms: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology*; D005260:Female; D006487:Hemostasis / Q000276:immunology*; D006801:Humans; D008074:Lipoproteins / Q000097:blood; D008297:Male; D008875:Middle Aged; D010741:Phospholipases A / Q000097:blood* / Q000276:immunology; D054467:Phospholipases A2; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D008074:Lipoproteins; D010741:Phospholipases A; D054467:Phospholipases A2; D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase