title: Alteration in lipoprotein-associated phospholipase A2 levels during acute coronary syndrome and its relationship to standard biomarkers.
abstract: BACKGROUND
  Lipoprotein-associated phospholipase A2 (Lp-PLA2) probably plays an important role in the development of acute coronary syndrome (ACS); elevated levels of Lp-PLA2 are associated with a poorer prognosis in patients with ischemic heart disease. Alterations of Lp-PLA2 levels during ACS and its relationship to standard biomarkers are, however, unclear.
  
  
  RESULTS
  Fifty-one consecutive ACS patients were enrolled in the study. All were managed with early invasive strategy and according to the current guidelines for pharmacotherapy; intensive statin therapy was started in all patients at admission. Serum levels of Lp-PLA2, LDL-cholesterol (LDL), troponin l (Tnl), and C-reactive protein (CRP) were assessed at admission (D0), on the first morning (D1), and on the second morning of hospitalization (D2). Mean serum levels of Lp-PLA2 (ng/mL) decreased from 264.6±19.1 at D0, to 193.2±14.4 at D1 (P < 0.001 vs. D0) and 189.8±22.6 at D2 (P = 0.002 vs. D0; P = not significant vs. D1). Alterations in Lp-PLA2 levels significantly correlated with changes in LDL (r = 0.43; P = 0.008). On the other hand, no relationship between Lp-PLA2 and Tnl or CRP was found.
  
  
  CONCLUSIONS
  Initially, serum levels of Lp-PLA2 were significantly elevated in ACS patients, but decreased within the first 24 hours after admission and subsequently remained stable. Lp-PLA2 levels correlated with LDL levels but not with Tnl or CRP levels. Our results demonstrated dynamic alterations in Lp-PLA2 levels during the early stages of ACS and, therefore, indirectly support the hypothesis of an active role for Lp-PLA2 in the pathogenesis of ACS.
authors.affiliation: Department of Cardiology, Heart Center, Na Homolce Hospital, Roentgenova 2, 15030 Prague, Czech Republic. ostadal.petr@gmail.com
authors.forename: Petr
authors.initials: P
authors.lastname: Ostadal
authors.forename: Dagmar
authors.initials: D
authors.lastname: Vondrakova
authors.forename: Andreas
authors.initials: A
authors.lastname: Kruger
authors.forename: Marek
authors.initials: M
authors.lastname: Janotka
authors.forename: Hana
authors.initials: H
authors.lastname: Psotova
authors.forename: Miroslav
authors.initials: M
authors.lastname: Prucha
mesh_terms: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000097:blood / Q000235:genetics; D054058:Acute Coronary Syndrome / Q000097:blood / Q000235:genetics / Q000503:physiopathology; D000368:Aged; D000596:Amino Acids / Q000008:administration & dosage / Q000009:adverse effects; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D014336:Troponin / Q000097:blood
chemical_list: D000596:Amino Acids; D015415:Biomarkers; D008078:Cholesterol, LDL; D014336:Troponin; D002097:C-Reactive Protein; D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase; C013165:statine