title: Phospholipase A2 in patients with noncardioembolic ischemic stroke and severe inflammatory reaction.
abstract: The inflammatory reaction is characterized by increased circulatory levels of various indicators of the severity of inflammation. The objective was to investigate the value of lipoprotein-associated phospholipase A2 (Lp-PLA2) in patients with noncardioembolic ischemic stroke and severe proinflammatory reaction. There were investigated prospectively Lp-PLA2 levels in sera from 47 patients with ischemic stroke and severe inflammatory reaction (32 men and 15 women, mean age 63 +/- 4.23 years) as compared to 38 patients with ischemic stroke without inflammatory reaction (21 men and 17 women, mean age 61 +/- 5.52 years) and 114 healthy elderly controls. Lp-PLA2 levels were assessed using the diaDexus PLAC test (a noncompetitive ELISA). Out of 47 patients with ischemic stroke and severe inflammatory reaction 36 presented Lp-PLA2 high levels (79%). Lp-PLA2 was detected with high levels in 17 out of 30 patients with ischemic stroke without inflammatory reaction (45%). Patients with ischemic stroke and severe inflammatory reaction presented Lp-PLA2 with high levels more frequently than the healthy controls (RR 12.1 [95% CI. 6.22 to 19.333], p<0.0001). Levels of Lp-PLA2 were higher in subjects who experienced a stroke as compared to controls. Lp-PLA2 is a strong predictor of recurrent stroke risk and of increased risk of dying. The determination of Lp-PLA2 should be used to predict patient risk of cardiovascular disease and stroke; it does provide additional risk of inflammation when used in conjunction with the traditional markers. Lp-PLA2 might be used not only for risk stratification of stroke patients, but also as target for treatment.
authors.affiliation: "Carol Davila" University of Medicine and Pharmacy, Department of Neurology, Colentina Clinical Hospital, Bucharest, Romania. mcojocar@cmb.ro
authors.forename: Inimoara Mihaela
authors.initials: IM
authors.lastname: Cojocaru
authors.forename: M
authors.initials: M
authors.lastname: Cojocaru
authors.forename: R
authors.initials: R
authors.lastname: Tănăsescu
authors.forename: Iuliana
authors.initials: I
authors.lastname: Iliescu
authors.forename: Laura
authors.initials: L
authors.lastname: Dumitrescu
authors.forename: Cecilia
authors.initials: C
authors.lastname: Burcin
authors.forename: Camelia Vidiţia
authors.initials: CV
authors.lastname: Gurban
authors.forename: Felicia
authors.initials: F
authors.lastname: Sfrijan
mesh_terms: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000097:blood* / Q000276:immunology; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000201:enzymology* / Q000276:immunology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007249:Inflammation / Q000201:enzymology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000201:enzymology* / Q000276:immunology
chemical_list: D015415:Biomarkers; D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase