Holst-Albrechtsen Sine, Kjaergaard Maria, Huynh Anh-Nhi Thi, Sorensen Johanne Kragh, Hosbond Susanne, Nybo Mads
Dept. of Clinical Biochemistry and Pharmacology, Odense University Hospital, Sdr. Boulevard 29, DK-5000 Odense, Denmark.
Curr Cardiol Rev. 2013 Nov;9(4):310-5. doi: 10.2174/1573403x09666131202143349.
Studies indicate that elevated plasma concentrations of lipoprotein-associated phospholipase A2 (Lp-PLA2) is associated with increased risk of cardiovascular disease. Lp-PLA2 seems to play a crucial role in the formation of plaques and acute inflammation, and plasma Lp-PLA2 could therefore potentially be used as a predictor of long-term outcome in ACS patients. To evaluate this, data concerning Lp-PLA2 as a predictor in ACS patients was gathered through a systematic literature review, and studies on this issue were extracted from relevant databases, incl. PubMed and Cochrane. A total of 14 articles were retrieved, but after thorough evaluation and elimination of irrelevant articles only seven studies were eligible for the literature review. All studies except two showed significant correlation between Lp-PLA2 and CV events in ACS patients. Only one study found an independent value to predict CV events 30 days after ACS. Altogether, there was inconsistency in the findings regarding the potential use of Lp-PLA2 and a lack of knowledge on several issues. Lp-PLA2 seems to give valuable information on which ACS patients are prone to new events and also provides important information on plaque size. However, more focused studies concerning genetic variations, time-window impact, patients with and without CV risk factors (e.g. diabetes), and treatment effects are needed. In conclusion, Lp-PLA2 offers new insight in the pathophysiological development of ACS, but until the aforementioned issues are addressed the biomarker will mainly be of interest in a research setting, not as a predictive parameter in a clinical setting.
研究表明，脂蛋白相关磷脂酶A2（Lp-PLA2）的血浆浓度升高与心血管疾病风险增加相关。Lp-PLA2似乎在斑块形成和急性炎症中起关键作用，因此血浆Lp-PLA2有可能用作急性冠状动脉综合征（ACS）患者长期预后的预测指标。为了对此进行评估，通过系统的文献综述收集了有关Lp-PLA2作为ACS患者预测指标的数据，并从包括PubMed和Cochrane在内的相关数据库中提取了关于此问题的研究。总共检索到14篇文章，但经过全面评估并剔除无关文章后，只有7项研究符合文献综述的要求。除两项研究外，所有研究均表明ACS患者的Lp-PLA2与心血管事件之间存在显著相关性。只有一项研究发现Lp-PLA2具有预测ACS后30天心血管事件的独立价值。总体而言，关于Lp-PLA2潜在用途的研究结果存在不一致性，并且在几个问题上缺乏相关知识。Lp-PLA2似乎能提供有关哪些ACS患者易发生新事件的有价值信息，还能提供有关斑块大小的重要信息。然而，需要开展更具针对性的研究，涉及基因变异、时间窗影响、有无心血管危险因素（如糖尿病）的患者以及治疗效果等方面。总之，Lp-PLA2为ACS的病理生理发展提供了新的见解，但在上述问题得到解决之前，该生物标志物主要在研究环境中具有意义，而不是作为临床环境中的预测参数。
