title: Lipoprotein-associated phospholipase A(2) activity is associated with large-artery atherosclerotic etiology and recurrent stroke in TIA patients.
abstract: BACKGROUND
  Lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) has emerged as a novel biomarker in cardiovascular diseases due to its ability to predict stroke in population-based studies. We aimed to investigate Lp-PLA(2) levels in transient ischemic attack (TIA) patients and to study their relationship with stroke recurrence.
  
  
  METHODS
  Lp-PLA(2) mass and activity were measured by means of the PLAC test with an automated Olympus analyzer and by a colorimetric activity method (diaDexus) in 166 TIA patients and 144 healthy controls. Vascular risk factors and stroke etiology were assessed. Outcome was defined as the presence of recurrent stroke/TIA within 7 and 30 days after the index TIA. Multivariate analyses were performed to identify potential predictors of recurrence.
  
  
  RESULTS
  Both Lp-PLA(2) mass and activity (p < 0.05) were higher in TIA than in controls. Several risk factors or previous treatments were associated with Lp-PLA(2) mass and activity level. During follow-up, 20 strokes/TIA (12%) occurred within the first 30 days and the presence of a large-artery atherosclerosis etiology of stroke (HR 3.28, p = 0.011), together with the past medical history of hyperlipidemia (HR 3.68, p = 0.008) and Lp-PLA(2) activity of >207 nmol/ml/min (HR 2.7, p = 0.042) were all significant predictors for recurrent stroke/TIA.
  
  
  CONCLUSIONS
  Lp-PLA(2) activity might add significant prognostic information in the early evaluation of TIA patients.
authors.affiliation: Neurovascular Research Laboratory and Department of Neurology, Universitat Autònoma de Barcelona.
authors.forename: Pilar
authors.initials: P
authors.lastname: Delgado
authors.forename: Pilar
authors.initials: P
authors.lastname: Chacón
authors.forename: Anna
authors.initials: A
authors.lastname: Penalba
authors.forename: Dolors
authors.initials: D
authors.lastname: Pelegri
authors.forename: Teresa
authors.initials: T
authors.lastname: García-Berrocoso
authors.forename: Dolors
authors.initials: D
authors.lastname: Giralt
authors.forename: Estevo
authors.initials: E
authors.lastname: Santamarina
authors.forename: Marc
authors.initials: M
authors.lastname: Ribó
authors.forename: Olga
authors.initials: O
authors.lastname: Maisterra
authors.forename: José
authors.initials: J
authors.lastname: Alvarez-Sabín
authors.forename: Anna
authors.initials: A
authors.lastname: Rosell
authors.forename: Joan
authors.initials: J
authors.lastname: Montaner
mesh_terms: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000097:blood*; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000201:enzymology / Q000401:mortality; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003124:Colorimetry; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000097:blood / Q000175:diagnosis / Q000201:enzymology / Q000209:etiology* / Q000401:mortality; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D054467:Phospholipases A2 / Q000097:blood*; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain; D020521:Stroke / Q000097:blood / Q000175:diagnosis / Q000201:enzymology / Q000209:etiology* / Q000401:mortality; D013997:Time Factors
chemical_list: D015415:Biomarkers; D054467:Phospholipases A2; D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase; C526684:PLA2G7 protein, human