Corsetti James P, Rainwater David L, Moss Arthur J, Zareba Wojciech, Sparks Charles E
Department of Pathology and Laboratory Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA.
Clin Chem. 2006 Jul;52(7):1331-8. doi: 10.1373/clinchem.2006.066845. Epub 2006 May 18.
Recent studies demonstrate that lipoprotein-associated phospholipase A2 (Lp-PLA2) is a risk factor for cardiovascular disease presumably deriving from generation of proinflammatory and proatherogenic species through its hydrolytic activity on lipoprotein-associated phospholipids. The goal of this study was to assess the relationship of Lp-PLA2 with a set of thrombogenic, lipid, inflammatory, and metabolic blood markers and to determine whether plasma Lp-PLA2 is a risk factor for recurrent coronary events in postinfarction patients.
Factor analysis on the set of blood markers and Lp-PLA2 was performed for 766 patients of the Thrombogenic Factors and Recurrent Coronary Events (THROMBO) postinfarction study. Recurrent coronary event risk was assessed as a function of blood marker concentrations and Lp-PLA2 by Cox proportional hazards multivariable regression adjusted for significant clinical covariates.
Factor analysis revealed that Lp-PLA2 was associated with one factor dominated by cholesterol and apolipoprotein B and another factor dominated by HDL-cholesterol and triglycerides, with little association with an inflammatory factor dominated by C-reactive protein. Multivariable analysis demonstrated as significant and independent predictors of risk of secondary coronary events only apolipoprotein B in a model without Lp-PLA2 (hazard ratio, 1.66; 95% confidence interval, 1.14-2.40) and only Lp-PLA2 in a model with Lp-PLA2 included [1.90 (1.31-2.75)].
Lp-PLA2 is a significant and independent predictor of risk for recurrent coronary events in postinfarction patients, and Lp-PLA2 is related to both hypercholesterolemia and high triglyceride-low HDL dyslipidemia in this study population.
近期研究表明，脂蛋白相关磷脂酶A2（Lp-PLA2）是心血管疾病的一个危险因素，可能是因其对脂蛋白相关磷脂具有水解活性，从而产生促炎和促动脉粥样硬化物质。本研究的目的是评估Lp-PLA2与一组血栓形成、脂质、炎症和代谢血液标志物之间的关系，并确定血浆Lp-PLA2是否为心肌梗死后患者复发性冠状动脉事件的危险因素。
对血栓形成因素与复发性冠状动脉事件（THROMBO）心肌梗死后研究中的766例患者进行了血液标志物和Lp-PLA2的因子分析。通过对显著临床协变量进行校正的Cox比例风险多变量回归，将复发性冠状动脉事件风险评估为血液标志物浓度和Lp-PLA2的函数。
因子分析显示，Lp-PLA2与一个以胆固醇和载脂蛋白B为主的因子以及另一个以高密度脂蛋白胆固醇和甘油三酯为主的因子相关，与以C反应蛋白为主的炎症因子几乎没有关联。多变量分析表明，在不含Lp-PLA2的模型中，只有载脂蛋白B是继发性冠状动脉事件风险的显著且独立预测因子（风险比，1.66；95%置信区间，1.14 - 2.�0），而在包含Lp-PLA{2}的模型中，只有Lp-PLA2是显著且独立预测因子[1.90（1.31 - 2.75）]。
Lp-PLA2是心肌梗死后患者复发性冠状动脉事件风险的显著且独立预测因子，并且在本研究人群中，Lp-PLA2与高胆固醇血症以及高甘油三酯 - 低高密度脂蛋白血脂异常均相关。
