Cai Anping, Li Guang, Chen Jiyan, Li Xida, Li Liwen, Zhou Yingling
Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106Zhongshan Road 2, Guangzhou, 510080, China.
BMC Cardiovasc Disord. 2015 Feb 26;15:14. doi: 10.1186/s12872-015-0001-9.
Lipoprotein-associated phospholipase A2 (Lp-PLA2) plays complex and adverse roles on atherosclerosis. Current study was to investigate whether increased plasma Lp-PLA2 level is independently associated with the severity of coronary artery diseases (CAD).
Totally 781 participants were enrolled and performed coronary angiography (CAG) to figure out the number of coronary artery stenosis. According to clinical presentation, electrocardiography, cardiac biomarker, and CAG result, participants were divided into control (excluded CAD), stable angina (SA), unstable angina (UA) and acute myocardial infarction (AMI) groups. Baseline characteristics were recorded. Statistical analyses were performed to evaluate the relationship between Lp-PLA2 level and CAD severity.
Plasma levels of Lp-PLA2 in control, SA, UA and AMI groups were 7.38(3.33-9.26) μg/L, 5.94(2.89-8.55) μg/L, 8.56(5.34-11.95) μg/L and 8.68(5.56-13.27) μg/L respectively (P < 0.001). After adjusted for age, gender, smoking, diabetes mellitus, hypertension, low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), apoprotein A (apoA) and statins, Lp-PLA2 level was still independently associated with CAD severity, with odd ratio (OR) of 1.055 (AMI group versus control group, 95% confidence interval (CI) 1.021-1.090, P < 0.05). Additionally, the relationship between Lp-PLA2 level and the number of stenosis coronary artery was also assessed. Lp-PLA2 levels in control, single-vessel, and multiple-vessels stenosis groups were 7.38(3.33-9.26) μg/L, 7.80 (4.05-10.76) μg/L and 8.29(5.18-11.76) μg/L respectively (P for trend < 0.001). After adjusted for age, gender, smoking, diabetes mellitus, hypertension, LDL-C and HDL-C, apoA and statins, Lp-PLA2 level remained independently associated with the number of coronary artery stenosis, with OR of 1.053 (multiple-vessels stenosis group versus control group, 95% CI 1.025-1.069, P < 0.05).
Increased Lp-PLA2 level is independently associated with CAD severity, and Lp-PLA2 level may be used to discriminate those who are at increased risk of cardiovascular events.
脂蛋白相关磷脂酶A2（Lp-PLA2）在动脉粥样硬化中发挥着复杂且有害的作用。当前研究旨在探讨血浆Lp-PLA2水平升高是否与冠状动脉疾病（CAD）的严重程度独立相关。
共纳入781名参与者，进行冠状动脉造影（CAG）以明确冠状动脉狭窄的数量。根据临床表现、心电图、心脏生物标志物及CAG结果，将参与者分为对照组（排除CAD）、稳定型心绞痛（SA）、不稳定型心绞痛（UA）和急性心肌梗死（AMI）组。记录基线特征。进行统计分析以评估Lp-PLA2水平与CAD严重程度之间的关系。
对照组、SA组、UA组和AMI组的血浆Lp-PLA2水平分别为7.38（3.33 - 9.26）μg/L、5.94（2.89 - 8.55）μg/L、8.56（5.34 - 11.95）μg/L和8.68（5.56 - 13.27）μg/L（P < 0.001）。在调整年龄､性别､吸烟､糖尿病､高血压､低密度脂蛋白胆固醇（LDL-C）､高密度脂蛋白胆固醇（HDL-C）､载脂蛋白A（apoA）和他汀类药物后，Lp-PLA2水平仍与CAD严重程度独立相关，比值比（OR）为1.055（AMI组与对照组相比，95%置信区间（CI）1.021 - 1.090，P < 0.05）。此外，还评估了Lp-PLA2水平与冠状动脉狭窄数量之间的关系。对照组、单支血管狭窄组和多支血管狭窄组的Lp-PLA2水平分别为7.38（3.33 - 9.26）μg/L、7.80（4.05 - 10.76）μg/L和8.29（5.18 - 11.76）μg/L（趋势P < 0.001）。在调整年龄､性别､吸烟､糖尿病､高血压､LDL-C和HDL-C､apoA和他汀类药物后，Lp-PLA2水平仍与冠状动脉狭窄数量独立相关，OR为1.053（多支血管狭窄组与对照组相比，95% CI 1.025 - 1.069，P < 0.05）。
Lp-PLA2水平升高与CAD严重程度独立相关，且Lp-PLA2水平可用于鉴别心血管事件风险增加的人群。
