The plasma concentration of Lpa-I:A-II particles as a predictor of the inflammatory response in patients with ST-elevation myocardial infarction.
OBJECTIVE
To investigate the relationship between plasma HDL at admission and the extent of the inflammatory response during an ST-elevation myocardial infarction (STEMI), and to analyse structural HDL changes during STEMI as related to the extent of inflammation.


RESULTS
CRP and IL-6 were monitored for 96h in 45 patients with STEMI. Plasma apoA-II and LpA-I:A-II levels at admission, but not HDL cholesterol or other HDL-related biomarkers, were associated with the extent of the inflammatory response during STEMI, as indicated by the positive correlations with CRP AUC (apoA-II: F=7.44, p=0.009; LpA-I:A-II: F=14.29, p<0.001), and IL-6 AUC (apoA-II: F=6.98, p=0.012; LpA-I:A-II: F=6.67, p=0.013). By multivariate analysis the plasma LpA-I:A-II level at admission was a powerful independent predictor of the inflammatory response, evaluated either as CRP AUC (F=22.30, p<0.001), or IL-6 AUC (F=6.92, p=0.012). During STEMI, the plasma concentration of LpA-I:A-II, but not LpA-I particles decreased, HDL became larger and progressively enriched in serum amyloid A; these changes occurred only in patients with a significant inflammatory response.


CONCLUSIONS
An elevated plasma concentration of LpA-I:A-II particles was an independent predictor of a more severe inflammatory response in patients with STEMI.
Gomaraschi
Monica
M
Center E. Grossi Paoletti, Department of Pharmacological Sciences, University of Milano, Italy.
Sinagra
Gianfranco
G
Serdoz
Laura Vitali
LV
Pitzorno
Cristina
C
Fonda
Maurizio
M
Cattin
Luigi
L
Calabresi
Laura
L
Franceschini
Guido
G
D000368:Aged; D000369:Aged, 80 and over; D016632:Apolipoprotein A-I / Q000097:blood*; D016633:Apolipoprotein A-II / Q000097:blood*; D002097:C-Reactive Protein / Q000096:biosynthesis; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007249:Inflammation; D015850:Interleukin-6 / Q000097:blood; D017270:Lipoprotein(a) / Q000097:blood*; D008075:Lipoproteins, HDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction
D016632:Apolipoprotein A-I; D016633:Apolipoprotein A-II; D015850:Interleukin-6; D017270:Lipoprotein(a); D008075:Lipoproteins, HDL; D002097:C-Reactive Protein