title: Lipoprotein-associated phospholipase A₂ is related to plaque stability and is a potential biomarker for acute coronary syndrome.
abstract: OBJECTIVE
  Plasma lipoprotein-associated phospholipase A₂ (Lp-PLA₂) binds to low-density lipoprotein. The levels of Lp-PLA₂ reflect the plaque burden, and are upregulated in acute coronary syndrome (ACS). We investigated the diagnostic value of Lp-PLA2 levels and found that it might be a potential biomarker for ACS.
  
  
  METHODS
  We classified 226 study participants into three groups: patients without significant stenosis (control group), patients with significant stenosis with stable angina (SA group), and patients with ACS (ACS group).
  
  
  RESULTS
  Lp-PLA₂ and high-sensitivity C-reactive protein (hs-CRP) levels were significantly greater in the ACS group than in the SA group (p=0.044 and p=0.029, respectively). Multivariate logistic regression analysis revealed that Lp-PLA₂ levels are significantly associated with ACS (odds ratio=1.047, p=0.013). The addition of Lp-PLA₂ to the ACS model significantly increased the global χ² value over traditional risk factors (28.14 to 35.602, p=0.006). The area under the receiver operating characteristic curve for Lp-PLA₂ was 0.624 (p=0.004). The addition of Lp-PLA₂ level to serum hs-CRP concentration yielded an integrated discrimination improvement of 0.0368 (p=0.0093, standard error: 0.0142) and improved the ability to diagnose ACS.
  
  
  CONCLUSIONS
  Lp-PLA₂ levels are related to plaque stability and might be a diagnostic biomarker for ACS.
authors.affiliation: Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hyemoon
authors.initials: H
authors.lastname: Chung
authors.affiliation: Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hyuck Moon
authors.initials: HM
authors.lastname: Kwon
authors.affiliation: Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jong-Youn
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Young-Won
authors.initials: YW
authors.lastname: Yoon
authors.affiliation: Cardiology Division, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jihyuk
authors.initials: J
authors.lastname: Rhee
authors.affiliation: Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Eui-Young
authors.initials: EY
authors.lastname: Choi
authors.affiliation: Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Pil-Ki
authors.initials: PK
authors.lastname: Min
authors.affiliation: Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Bum-Kee
authors.initials: BK
authors.lastname: Hong
authors.affiliation: Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Se-Joong
authors.initials: SJ
authors.lastname: Rim
authors.affiliation: Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Yoon
authors.affiliation: Cardiology Division, Department of Internal Medicine, Chungju Medical Center, Chungju, Korea.
authors.forename: Sung-Joo
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Cardiology Division, Department of Internal Medicine, NHIC Ilsan Hospital, Goyang, Korea.
authors.forename: Jong-Kwan
authors.initials: JK
authors.lastname: Park
authors.affiliation: Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Myung-Hyun
authors.initials: MH
authors.lastname: Kim
authors.affiliation: Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Minhee
authors.initials: M
authors.lastname: Jo
authors.affiliation: Department of Biochemistry, CHA University College of Medicine, Seongnam, Korea.
authors.forename: Jeong-Hee
authors.initials: JH
authors.lastname: Yang
authors.affiliation: Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. cardiobk@yuhs.ac.
authors.forename: Byoung Kwon
authors.initials: BK
authors.lastname: Lee
mesh_terms: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000097:blood*; D054058:Acute Coronary Syndrome / Q000097:blood* / Q000503:physiopathology; D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D008077:Lipoproteins, LDL / Q000097:blood*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D058226:Plaque, Atherosclerotic / Q000097:blood; D012372:ROC Curve; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D008077:Lipoproteins, LDL; D002097:C-Reactive Protein; D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase; C526684:PLA2G7 protein, human
keywords: Lp-PLA₂; acute coronary syndrome; biomarker; coronary atherosclerotic plaque instability