Decreased circulating lipoprotein-associated phospholipase A2 levels are associated with coronary plaque regression in patients with acute coronary syndrome.
OBJECTIVE
Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a vascular-specific inflammatory enzyme, of which increases are associated with cardiovascular events. However, the relationship between circulating Lp-PLA2 levels and coronary plaque volume has not been clarified in patients with acute coronary syndrome (ACS).


METHODS
We studied 40 patients with ACS (age, 61.4 ± 8.0 years; male, 87.5%; statin use, 45.0%) who had undergone successful percutaneous coronary intervention (PCI). Plaque volume (PV) in non-culprit sites of PCI lesions was precisely determined using grayscale intravascular ultrasound (IVUS) at onset and at six months later. We then analyzed associations among PV, lipid profiles and Lp-PLA2 levels.


RESULTS
Circulating Lp-PLA2 levels and PV significantly decreased between baseline and six months of follow-up (458.6 ± 166.7 IU/L vs. 378.4 ± 158.5 IU/L, p < 0.001 and 82.2 ± 34.8mm(3) vs. 77.3 ± 33.1mm(3), p < 0.001, respectively). The % change in PV positively and significantly correlated with % change in LDL-C and in the LDL-C/HDL-C ratio (r = 0.444, p = 0.004 and r = 0.462, p = 0.003, respectively). Furthermore, % changes in Lp-PLA2 and in PV correlated even more closely (r = 0.496, p = 0.001). The absolute change in PV also significantly correlated with the change in Lp-PLA2 levels (r = 0.404, p = 0.009).


CONCLUSIONS
Circulating Lp-PLA2 levels are associated with changes in coronary plaque determined by IVUS in patients with ACS.
Department of Cardiovascular Medicine, Juntendo University School of Medicine, Japan.
Tomotaka
T
Dohi
Katsumi
K
Miyauchi
Shinya
S
Okazaki
Takayuki
T
Yokoyama
Ryunosuke
R
Ohkawa
Kazuhiro
K
Nakamura
Naotake
N
Yanagisawa
Shuta
S
Tsuboi
Manabu
M
Ogita
Ken
K
Yokoyama
Takeshi
T
Kurata
Yutaka
Y
Yatomi
Hiroyuki
H
Daida
D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000097:blood*; D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging / Q000201:enzymology* / Q000628:therapy; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000097:blood; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000201:enzymology* / Q000628:therapy; D015536:Down-Regulation; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D007564:Japan; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D054467:Phospholipases A2 / Q000097:blood*; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging / Q000201:enzymology* / Q000628:therapy; D011446:Prospective Studies; D012044:Regression Analysis; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
D015415:Biomarkers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D054467:Phospholipases A2; D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase; C526684:PLA2G7 protein, human