title: Lipoprotein-associated phospholipase A2 testing usefulness among patients with symptomatic intracranial atherosclerotic disease.
abstract: OBJECTIVE
  Circulating lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) has emerged as a novel biomarker for cardiovascular diseases. Our aim was to determine Lp-PLA(2) mass and activity in a selected cohort of first-ever transient ischemic attack (TIA) or ischemic stroke patients with intracranial atherosclerotic disease (ICAD) and to investigate its relationship with the presence of classical vascular risk factors, response to secondary prevention treatments and risk of recurrent vascular events.
  
  
  METHODS
  Lp-PLA(2) mass and activity were measured 3 months after TIA or stroke by means of the PLAC test and CAM-assay (diaDexus, Inc.) respectively in 75 patients. Classic vascular risk factors, preventive treatments and clinical characteristics at the time of the index event were recorded. Follow-up transcranial Doppler ultrasonography (TCD) was performed and the presence of a new vascular event was assessed every 6 months.
  
  
  RESULTS
  Several preventive treatments (statins and clopidogrel) were significantly associated with lower Lp-PLA(2) mass and activity. During follow-up (median time 23 months), eighteen patients (24%) suffered a new vascular event. Baseline factors associated with new vascular events were: history of coronary artery disease, number of intracranial stenoses detected by TCD and also Lp-PLA(2) activity, which was the only independent predictor for new vascular events (hazard ratio 2.89; 95% CI 1.029 to 8.096; p=0.044) after multivariate analysis (Cox regression).
  
  
  CONCLUSIONS
  Lp-PLA(2) activity might be a useful tool to identify intracranial large-artery occlusive disease patients at higher risk of suffering new vascular events.
authors.affiliation: Neurovascular Research Laboratory, Department of Neurology, Autonomous University of Barcelona, Vall d'Hebron Hospital, Barcelona, Spain.
authors.forename: Andreu
authors.initials: A
authors.lastname: Massot
authors.forename: Dolors
authors.initials: D
authors.lastname: Pelegri
authors.forename: Anna
authors.initials: A
authors.lastname: Penalba
authors.forename: Juan
authors.initials: J
authors.lastname: Arenillas
authors.forename: Cristina
authors.initials: C
authors.lastname: Boada
authors.forename: Dolors
authors.initials: D
authors.lastname: Giralt
authors.forename: Marc
authors.initials: M
authors.lastname: Ribó
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Molina
authors.forename: Anna
authors.initials: A
authors.lastname: Rosell
authors.forename: José
authors.initials: J
authors.lastname: Alvarez-Sabín
authors.forename: Pilar
authors.initials: P
authors.lastname: Chacón
authors.forename: Alex
authors.initials: A
authors.lastname: Rovira
authors.forename: Pilar
authors.initials: P
authors.lastname: Delgado
authors.forename: Joan
authors.initials: J
authors.lastname: Montaner
mesh_terms: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000097:blood*; D000368:Aged; D050197:Atherosclerosis / Q000097:blood*; D001927:Brain Diseases / Q000097:blood; D002560:Cerebrovascular Circulation; D003324:Coronary Artery Disease / Q000097:blood; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000097:blood; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012008:Recurrence; D012306:Risk; D012307:Risk Factors; D013997:Time Factors; D018608:Ultrasonography, Doppler / Q000379:methods
chemical_list: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase