[Lipoprotein-associated phospholipase A(2) and stroke].
BACKGROUND
Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an enzyme member of A2 phosholipases superfamily. The 80% circulates bound to LDL-cholesterol and levels of both parameters are positively correlated. The main function of this enzyme is to hydrolyze oxidized phospholipids contained in LDL-cholesterol forming pro-inflammatory products in atheroma plaque. Several studies related raised Lp-PLA2 and vascular risk.


OBJECTIVE
To review available data relating Lp-PLA2 and stroke.


METHODS
Different cohorts and cases and controls studies showed an association between higher levels of Lp-PLA2 and the risk of suffering: first cardiovascular event (coronary heart disease, ischemic stroke) or its recurrence; progression of coronary damage evaluated using cardiac computed tomography; or death of cardiovascular cause. Published risk measurements are less than 2 and it has been demonstrated that raised levels of enzyme are risk factor independent of classic cardiovascular risk factors and non-HDL cholesterol and C-reactive protein levels. The clinical data and the knowledge of the role of Lp-PLA2 in plaque destabilization justified the development of inhibitor drugs.


CONCLUSIONS
According to current evidence, patients in the higher range of Lp-PLA2 may be considerate at higher risk of suffering a vascular event. The application to stroke needs a better definition of the pathophysiologic role and the knowledge of phase II clinical trials currently under development in coronary heart disease.
Alvarez-Pérez
F J
FJ
Departamento de Medicina, Facultad de Ciencias de la Salud, Universidad de Beira Interior, Hospital de Covilhã, Covilhã, Portugal. franciscoplus@hotmail.com
Verde
I
I
D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000097:blood*; D002318:Cardiovascular Diseases / Q000201:enzymology / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D012307:Risk Factors; D020521:Stroke / Q000201:enzymology* / Q000453:epidemiology / Q000209:etiology
D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase