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脂蛋白相关性磷脂酶A2水平与冠状动脉疾病危险因素、血管造影冠状动脉病变以及随访期间主要不良事件的关系

Association of lipoprotein- associated phospholipase A2 levels with coronary artery disease risk fartors, angiographic coronary artery disease, and major adverse events at follow- up
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摘要 Aims: We aimed to evaluate the association of lipoprotein- associated phospholipase A2(Lp- PLA2) with coronary artery disease(CAD) risk factors, with the severity of angiographic CAD, and with the incidence of major adverse events. Methods and results: We measured Lp- PLA2 levels in 504 consecutive patients undergoing clinically indicated coronary angiography. Mean age was 60± 11 years and 38% were women. The mean(± SD) Lp- PLA2 level(ng/mL) was 245± 91. Lp- PLA2 levels correlated with male gender, LDL, HDL, and total cholesterol, fibrinogen, and creatinine. Lp- PLA2 levels correlated with the extent of angiographic CAD on univariate but not on multivariable analysis. During a median follow- up of 4.0 years, 72 major adverse events occurred in 61 of 466(13% ) contacted patients(20 deaths, 14 myocardial infarctions, 28 coronary revascularizations, and 10 strokes). Higher Lp- PLA2 levels were associated with a greater risk of events: the hazard ratio per SD was 1.28(95% CI 1.06- 1.54, P=0.009), and remained significant after adjusting for clinical and lipid variables and C- reactive protein. Conclusion: Higher Lp- PLA2 levels were associated with a higher incidence of major adverse events at follow- up, independently of traditional CAD risk factors and C- reactive protein. Aims: We aimed to evaluate the association of lipoprotein- associated phospholipase A2(Lp- PLA2) with coronary artery disease(CAD) risk factors, with the severity of angiographic CAD, and with the incidence of major adverse events. Methods and results: We measured Lp- PLA2 levels in 504 consecutive patients undergoing clinically indicated coronary angiography. Mean age was 60± 11 years and 38% were women. The mean(± SD) Lp- PLA2 level(ng/mL) was 245± 91. Lp- PLA2 levels correlated with male gender, LDL, HDL, and total cholesterol, fibrinogen, and creatinine. Lp- PLA2 levels correlated with the extent of angiographic CAD on univariate but not on multivariable analysis. During a median follow- up of 4.0 years, 72 major adverse events occurred in 61 of 466(13% ) contacted patients(20 deaths, 14 myocardial infarctions, 28 coronary revascularizations, and 10 strokes). Higher Lp- PLA2 levels were associated with a greater risk of events: the hazard ratio per SD was 1.28(95% CI 1.06- 1.54, P=0.009), and remained significant after adjusting for clinical and lipid variables and C- reactive protein. Conclusion: Higher Lp- PLA2 levels were associated with a higher incidence of major adverse events at follow- up, independently of traditional CAD risk factors and C- reactive protein.
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