Lipoprotein-associated phospholipase A2: a risk marker or a risk factor?
Multiple cardiovascular biomarkers are associated with increased cardiovascular disease (CVD) risk. Lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) appears to be relatively unique in its high specificity for and the causal pathway of plaque inflammation. In both primary and secondary prevention study populations, Lp-PLA(2) was consistently associated with higher cardiovascular risk, and the risk estimate appears to be relatively unaffected by adjustment for conventional CVD risk factors. Risk ratios were similar, whether the mass concentration or activity of the enzyme was measured. The purpose of this article is to review the evidence for the clinical utility of Lp-PLA(2), both as a risk marker and as a risk factor involved in the causal pathway of plaque inflammation and the formation of rupture-prone plaque.
Lerman
Amir
A
Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA. lerman.amir@mayo.edu
McConnell
Joseph P
JP
D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood / Q000378:metabolism* / Q000517:prevention & control; D004730:Endothelium, Vascular / Q000503:physiopathology*; D006801:Humans; D007249:Inflammation / Q000378:metabolism*; D011322:Primary Prevention; D012307:Risk Factors; D012680:Sensitivity and Specificity
D015415:Biomarkers; D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase