title: Lipoprotein-associated phospholipase A2 is elevated in patients with severe aortic valve stenosis without clinically overt atherosclerosis.
abstract: BACKGROUND
  Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an inflammatory mediator involved in atherosclerosis. Since aortic valve stenosis (AVS) is regarded as an atherosclerosis-like inflammatory disease, we sought to investigate whether AVS is associated with elevated Lp-PLA2.
  
  
  METHODS
  Plasma Lp-PLA2 levels were determined in 48 consecutive patients with severe AVS without atherosclerotic vascular disease and compared with the values obtained in 48 controls matched for age, sex and cardiovascular risk factors.
  
  
  RESULTS
  Lp-PLA2 was higher in AVS than in controls (242.3±50.4 vs. 151.9±28.1 ng/mL, p<0.0001). Lp-PLA2 correlated inversely with aortic valve area (AVA) (r=-0.53; p=0.0001) and positively with mean pressure gradient (PG) (r=0.32; p=0.029). In multivariable analysis C-reactive protein (CRP) (OR=1.42; 95% CI 0.95-2.1; p=0.09) and AVA (OR=0.003; 95% CI 0.00004-0.23; p<0.01) were independently associated with Lp-PLA2 above a mean of 242 ng/mL. After adjustment for CRP, AVA was the only independent predictor of Lp-PLA2 in AVS patients (p<0.001).
  
  
  CONCLUSIONS
  This study is the first to show that AVS is characterized by increased plasma Lp-PLA2 levels associated with the severity of AVS, which suggests active involvement of Lp-PLA2 in the pathogenesis of AVS.
authors.affiliation: John Paul II Hospital, Krakow, Poland.
authors.forename: Renata
authors.initials: R
authors.lastname: Kolasa-Trela
authors.forename: Korneliusz
authors.initials: K
authors.lastname: Fil
authors.forename: Marta
authors.initials: M
authors.lastname: Bazanek
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Grudzień
authors.forename: Dorota
authors.initials: D
authors.lastname: Sobczyk
authors.forename: Jerzy
authors.initials: J
authors.lastname: Sadowski
authors.forename: Anetta
authors.initials: A
authors.lastname: Undas
mesh_terms: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000097:blood*; D001024:Aortic Valve Stenosis / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging / Q000201:enzymology*; D050197:Atherosclerosis / Q000150:complications; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014463:Ultrasonography
chemical_list: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase