title: Link between lipoprotein-associated phospholipase A2 gene expression of peripheral-blood mononuclear cells and prognostic outcome after acute ischemic stroke.
abstract: OBJECTIVE
  To evaluate the potential of the lipoprotein-associated phospholipase A(2) (Lp-PLA(2) level as a biomarker in the prediction of prognostic outcome in patients with acute ischemic stroke (IS).
  
  
  METHODS
  From October 2008 to March 2010, 130 patients with acute IS were prospectively enrolled in the study and their medical records were reviewed. A blood sample was collected from each patient 48 hours after acute IS, as well as from 20 healthy volunteers as controls. Messenger-RNA (mRNA) expression of Lp-PLA(2) of peripheral-blood mononuclear cells (PBMNCs) relative to that of β actin was measured using quantitative reverse transcription polymerase chain reaction (RT-PCR).
  
  
  RESULTS
  Patients with acute IS exhibited significantly higher Lp-PLA(2) mRNA expression of PBMNCs than the control group (p <0.0001). Lp-PLA(2) mRNA expression of PBMNCs in patients with a major adverse clinical outcome (MACO) (defined as recurrent stroke or death) within 90 days was significantly higher than in patients without MACO (p=0.006). Furthermore, elevated Lp-PLA(2) mRNA expression was strongly associated with old age, diabetes mellitus, a positive history of significant coronary arterial disease and significant stenosis of the extra-cranial carotid arteries (all p <0.04), and positively correlated with the body mass index, leukocyte count, and serum levels of total cholesterol and low-density lipoprotein cholesterol. Multivariate analysis revealed that Lp-PLA(2) mRNA expression of PBMNCs was a significant independent predictor of MACO within 90 days (p= 0.011).
  
  
  CONCLUSIONS
  Elevated Lp-PLA(2) mRNA expression of PBMNCs seems to be a potential biomarker for predicting an unfavorable outcome in patients with acute IS.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Tzu-Hsien
authors.initials: TH
authors.lastname: Tsai
authors.forename: Yung-Lung
authors.initials: YL
authors.lastname: Chen
authors.forename: Hung-Sheng
authors.initials: HS
authors.lastname: Lin
authors.forename: Chu-Feng
authors.initials: CF
authors.lastname: Liu
authors.forename: Hsuen-Wen
authors.initials: HW
authors.lastname: Chang
authors.forename: Cheng-Hsien
authors.initials: CH
authors.lastname: Lu
authors.forename: Wen-Neng
authors.initials: WN
authors.lastname: Chang
authors.forename: Shu-Feng
authors.initials: SF
authors.lastname: Chen
authors.forename: Chiung-Jen
authors.initials: CJ
authors.lastname: Wu
authors.forename: Steve
authors.initials: S
authors.lastname: Leu
authors.forename: Sheung-Fat
authors.initials: SF
authors.lastname: Ko
authors.forename: Hon-Kan
authors.initials: HK
authors.lastname: Yip
mesh_terms: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000097:blood* / Q000235:genetics; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007511:Ischemia / Q000097:blood* / Q000175:diagnosis / Q000235:genetics; D007963:Leukocytes, Mononuclear / Q000378:metabolism*; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D012333:RNA, Messenger / Q000235:genetics; D060888:Real-Time Polymerase Chain Reaction; D012008:Recurrence; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012307:Risk Factors; D020521:Stroke / Q000097:blood* / Q000175:diagnosis / Q000235:genetics
chemical_list: D015415:Biomarkers; D012333:RNA, Messenger; D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase