title: Role of lipoprotein-associated phospholipase A2 activity for the prediction of silent brain infarcts in women.
abstract: OBJECTIVE
  Lipoprotein-associated phospholipase A2 (Lp-PLA2), predicts risk of coronary events and stroke and might be associated with cerebral small vessel disease. We aimed to determine whether silent brain infarcts relate to Lp-PLA2 activity and also, whether the addition of Lp-PLA2 activity to prognostic clinical models improves silent brain infarcts' discrimination.
  
  
  METHODS
  Cross-sectional study in 921 stroke-free individuals. On baseline, demographic and vascular risk factors were collected and a brain magnetic resonance was performed to assess for the presence of silent brain infarcts. Serum Lp-PLA2 activity was tested by an enzymatic assay (PLAC Test for activity) for all study participants and 49 healthy individuals free of vascular risk factors. Multivariate analysis and Integrated Discrimination Improvement were performed to assess whether Lp-PLA2 activity was independently associated with silent brain infarcts and improved their discrimination added to clinical variables.
  
  
  RESULTS
  Lp-PLA2 activity was independently associated with silent brain infarcts in women (OR per one standard deviation increase: 2.14, from 1.31 to 3.50) but not in men (OR = 1.09, from 0.81 to 1.48) after adjustment by age, diastolic blood pressure, total cholesterol, statin treatment and other potential confounders. Adding Lp-PLA2 to clinical information for SBIs diagnosis resulted in a non-significant and mild improvement in discrimination (IDI = 3.1%) in women.
  
  
  CONCLUSIONS
  Although Lp-PLA2 is independently associated with silent brain infarcts in women, its addition to clinical variables does not lead to any improvement in their prediction.
authors.affiliation: Neurovascular Research Lab, Institut de Recerca Vall d'Hebron (VHIR), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
authors.forename: Iolanda
authors.initials: I
authors.lastname: Riba-Llena
authors.affiliation: Neurovascular Research Lab, Institut de Recerca Vall d'Hebron (VHIR), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
authors.forename: Anna
authors.initials: A
authors.lastname: Penalba
authors.affiliation: Clinical Biochemistry Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
authors.forename: Dolors
authors.initials: D
authors.lastname: Pelegrí
authors.affiliation: Neurovascular Research Lab, Institut de Recerca Vall d'Hebron (VHIR), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
authors.forename: Andrea
authors.initials: A
authors.lastname: Vilar
authors.affiliation: Emergency Department, CUAP Horta, Barcelona, Spain.
authors.forename: Carme I
authors.initials: CI
authors.lastname: Jarca
authors.affiliation: Clot Primary Care Center, Institut Català de Salut, Barcelona, Spain.
authors.forename: Josefina
authors.initials: J
authors.lastname: Filomena
authors.affiliation: Neurovascular Research Lab, Institut de Recerca Vall d'Hebron (VHIR), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Stroke Unit and Neurology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Montaner
authors.affiliation: Neurovascular Research Lab, Institut de Recerca Vall d'Hebron (VHIR), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain. Electronic address: pilar.delgado@vhir.org.
authors.forename: Pilar
authors.initials: P
authors.lastname: Delgado
mesh_terms: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000097:blood*; D000368:Aged; D050197:Atherosclerosis / Q000097:blood; D001794:Blood Pressure; D001921:Brain / Q000473:pathology; D020520:Brain Infarction / Q000097:blood*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000097:blood; D016896:Treatment Outcome
chemical_list: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase; C526684:PLA2G7 protein, human
keywords: Atherosclerosis; Brain infarction; Lipoprotein-associated phospholipase A(2); Platelet-activating factor Hydrolase; Stroke