Deputy Chief Physician, Department of Cardiology, Haimen Hospital of Nantong University, China.
Deputy Chief Physician, Department of Medical Imaging, Radiology Center, Haimen Hospital of Nantong University, China.
Scott Med J. 2021 Nov;66(4):178-185. doi: 10.1177/00369330211034809. Epub 2021 Jul 28.
Coronary in-stent restenosis (ISR) is an important complication of percutaneous coronary intervention (PCI). However, the relationship between lipoprotein associated phospholipase A2 (Lp-PLA2) level and ISR after PCI is rarely reported. This study aims to explore the relationship between Lp-PLA2 and the occurrence of ISR at post-PCI and its predictive value for ISR.
Plasma Lp-PLA2 mass were measured in 847 patients planting 1262 stents and evaluated along with known risk indicators. One-year angiographic follow-up showed that baseline elevated Lp-PLA2 mass was strongly associated with early restenosis (95% CI = 1.062-3.050, P < 0.05). Beyond the first year, the occurrence of late restenosis (95% CI = 1.043-3.214, P < 0.05) was significantly larger in the elevated Lp-PLA2 group. Kaplan-Meier analysis after three-year clinical follow up suggested that Lp-PLA2 mass did add the positive effect on the occurrence of major adverse cardiovascular events (MACEs).
In conclusion, increased baseline plasma Lp-PLA2 predicts increased risks of re-stenosis and MACEs, which may be a novel biomarker for predicting ISR and MACEs.
经皮冠状动脉介入治疗（PCI）后发生的冠状动脉支架内再狭窄（ISR）是一个重要的并发症。然而，脂蛋白相关磷脂酶 A2（Lp-PLA2）水平与 PCI 后 ISR 之间的关系鲜有报道。本研究旨在探讨 PCI 后 Lp-PLA2 与 ISR 发生的关系及其对 ISR 的预测价值。
在 847 例植入 1262 枚支架的患者中测量了血浆 Lp-PLA2 质量，并与已知的风险指标一起进行评估。一年的血管造影随访显示，基线时升高的 Lp-PLA2 质量与早期再狭窄（95%CI=1.062-3.050，P<0.05）密切相关。超过一年后，在 Lp-PLA2 升高组中晚期再狭窄（95%CI=1.043-3.214，P<0.05）的发生率显著更大。经过三年临床随访的 Kaplan-Meier 分析表明，Lp-PLA2 质量确实增加了发生主要不良心血管事件（MACEs）的阳性效应。
总之，基线血浆 Lp-PLA2 升高预示着再狭窄和 MACEs 的风险增加，这可能是预测 ISR 和 MACEs 的一个新的生物标志物。
