title: Lipoprotein-associated phospholipase A2 activity predicts cardiovascular events in high risk coronary artery disease patients.
abstract: OBJECTIVE
  Lipoprotein-associated phospholipase A2 (Lp-PLA2) is deemed to play a role in atherosclerosis and plaque destabilization as demonstrated in animal models and in prospective clinical studies. However, most of the literature is either focused on high-risk, apparently healthy patients, or is based on cross sectional studies. Therefore, we tested the hypothesis that serum Lp-PLA2 mass and activity are useful for predicting cardiovascular (CV) events over the coronary atherosclerotic burden and conventional risk factors in high-risk coronary artery disease patients.
  
  
  RESULTS
  In a prospective cohort study of 712 Caucasian patients, who underwent coronary angiography and measurement of both Lp-PLA2 mass and activity at baseline, we determined incident CV events at follow-up after splitting the patients into a high and a low Lp-PLA2 mass and activity groups based on ROC analysis and Youden index. Kaplan-Meier and propensity score matching analysis were used to compare CV event-free survival between groups. Follow-up data were obtained in 75% of the cohort after a median of 7.2 years (range 1-12.7 years) during which 129 (25.5%) CV events were observed. The high Lp-PLA2 activity patients showed worse CV event-free survival (66.7% vs. 79.5%, p = 0.023) and acute coronary syndrome-free survival (75.4% vs. 85.6%, p = 0.04) than those in low Lp-PLA2 group.
  
  
  CONCLUSIONS
  A high Lp-PLA2 activity implies a worse CV prognosis at long term follow up in high-risk Caucasian patients referred for coronary angiography.
authors.affiliation: Department of Medicine, Internal Medicine 4, University of Padua, Padua, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Maiolino
authors.forename: Luigi
authors.initials: L
authors.lastname: Pedon
authors.forename: Maurizio
authors.initials: M
authors.lastname: Cesari
authors.forename: Anna Chiara
authors.initials: AC
authors.lastname: Frigo
authors.forename: Robert L
authors.initials: RL
authors.lastname: Wolfert
authors.forename: Marlena
authors.initials: M
authors.lastname: Barisa
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Pagliani
authors.forename: Giacomo
authors.initials: G
authors.lastname: Rossitto
authors.forename: Teresa Maria
authors.initials: TM
authors.lastname: Seccia
authors.forename: Mario
authors.initials: M
authors.lastname: Zanchetta
authors.forename: Gian Paolo
authors.initials: GP
authors.lastname: Rossi
mesh_terms: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000097:blood* / Q000737:chemistry; D054058:Acute Coronary Syndrome / Q000097:blood / Q000000981:diagnostic imaging / Q000201:enzymology* / Q000401:mortality; D000368:Aged; D003324:Coronary Artery Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000201:enzymology* / Q000401:mortality; D003404:Creatinine / Q000097:blood; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D016014:Linear Models; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D008970:Molecular Weight; D015999:Multivariate Analysis; D011379:Prognosis; D057216:Propensity Score; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012372:ROC Curve; D011859:Radiography; D012307:Risk Factors
chemical_list: D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D003404:Creatinine; D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase