Can Lipoprotein-associated Phospholipase A₂ be Used as a Predictor of Long-term Outcome in Patients with Acute Coronary Syndrome?

Title:Can Lipoprotein-associated Phospholipase A₂ be Used as a Predictor of Long-term Outcome in Patients with Acute Coronary Syndrome?

Volume: 9 Issue: 4

Author(s): Sine Holst-Albrechtsen, Maria Kjaergaard, Anh-Nhi Thi Huynh, Johanne Kragh Sorensen, Susanne Hosbond and Mads Nybo

Affiliation:

Keywords: Acute coronary syndrome, biomarker, Lp-PLA₂, mortality, plaque rupture, prospective studies, statins.

Abstract: 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.

Cite this article as:

Holst-Albrechtsen Sine, Kjaergaard Maria, Huynh Thi Anh-Nhi, Sorensen Kragh Johanne, Hosbond Susanne and Nybo Mads, Can Lipoprotein-associated Phospholipase A₂ be Used as a Predictor of Long-term Outcome in Patients with Acute Coronary Syndrome?, Current Cardiology Reviews 2013; 9 (4) . https://dx.doi.org/10.2174/1573403X09666131202143349