Serum Level of Lipoprotein-Associated Phospholipase A2 and Coronary Artery Disease

Background: Cardiovascular diseases (CVDs) are on the rise owing to excessive fat consumption or hereditary factors. From infancy through old age, it is the leading cause of disease and mortality. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an enzyme mostly excreted by macrophages and neutrophils from atherosclerotic plaque, which subsequently circulates in the circulation. We aimed to evaluate the relation between plasma level of LP-PLA2 and severity of coronary artery disease (CAD).

Methods: This retrospective randomized case control study was conducted on 60 cases aged ≥ 18 years, presented by any form of CAD than ten healthy adults to determine the relation between plasma level of LP-PLA2 and severity of CAD. All cases were subjected to the following: Full history taking such as Socio-demographic study including age, sex, occupation, complain, history of illness: Including family history of CAD, history of smoking, hypertension and diabetes mellitus (DM).

Results: Significantly elevated LDL-C, LP-PLA2, and decreased HDL-C levels were also observed in patients with significant CAD. The HDL-C levels of individuals with CAD were significantly lower than those of healthy individuals. HDL-C levels in Control group (N=10) and CAD groups (SA=20, UA=20 and AMI=20) were 78.5, 38.95, 36.85, 32, respectively; there was highly significance relation between both group regarding HDL-C Level with (p-value=0.003). Plasma level of Lp-PLA2 was gradually elevated in parallel with the increased severity of CAD. There was highly significant difference among study groups regarding plasma level of Lp-PLA2. Lp-PLA2 plasma level in Control group (N=10) and CAD groups (SA=20, UA=20 and AMI=20) were 87.9, 216.95, 272.15, 379.95, respectively; (p-value=0.001) show gradually significant elevation. Lp-PLA2 level remained independently associated with coronary artery stenosis after adjustment for age, gender, smoking, diabetes, hypertension, LDL-C and HDL-C.

Conclusions: An increased plasma level of Lp-PLA2 is related with an unstable phenotype of coronary atherosclerotic plaque and a greater degree of coronary artery stenosis in individuals with coronary artery disease (CAD). Dynamic Lp-PLA2 monitoring may be predictive of cardiovascular disease risk. In recent years, there has been great interest in the capacity of Lp-PLA2 to predict and evaluate the prognosis of CVDs. In addition, Lp-PLA2 has been identified as an independent risk factor for the development and progression of coronary heart disease.