Lipoprotein-associated phospholipase A(2) activity is associated with large-artery atherosclerotic etiology and recurrent stroke in TIA patients

Cerebrovasc Dis. 2012;33(2):150-8. doi: 10.1159/000334193. Epub 2011 Dec 14.

Abstract

Background: Lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) has emerged as a novel biomarker in cardiovascular diseases due to its ability to predict stroke in population-based studies. We aimed to investigate Lp-PLA(2) levels in transient ischemic attack (TIA) patients and to study their relationship with stroke recurrence.

Methods: Lp-PLA(2) mass and activity were measured by means of the PLAC test with an automated Olympus analyzer and by a colorimetric activity method (diaDexus) in 166 TIA patients and 144 healthy controls. Vascular risk factors and stroke etiology were assessed. Outcome was defined as the presence of recurrent stroke/TIA within 7 and 30 days after the index TIA. Multivariate analyses were performed to identify potential predictors of recurrence.

Results: Both Lp-PLA(2) mass and activity (p < 0.05) were higher in TIA than in controls. Several risk factors or previous treatments were associated with Lp-PLA(2) mass and activity level. During follow-up, 20 strokes/TIA (12%) occurred within the first 30 days and the presence of a large-artery atherosclerosis etiology of stroke (HR 3.28, p = 0.011), together with the past medical history of hyperlipidemia (HR 3.68, p = 0.008) and Lp-PLA(2) activity of >207 nmol/ml/min (HR 2.7, p = 0.042) were all significant predictors for recurrent stroke/TIA.

Conclusions: Lp-PLA(2) activity might add significant prognostic information in the early evaluation of TIA patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • 1-Alkyl-2-acetylglycerophosphocholine Esterase / blood*
  • Aged
  • Aged, 80 and over
  • Atherosclerosis / blood
  • Atherosclerosis / complications*
  • Atherosclerosis / diagnosis
  • Atherosclerosis / enzymology
  • Atherosclerosis / mortality
  • Biomarkers / blood
  • Case-Control Studies
  • Chi-Square Distribution
  • Colorimetry
  • Female
  • Humans
  • Ischemic Attack, Transient / blood
  • Ischemic Attack, Transient / diagnosis
  • Ischemic Attack, Transient / enzymology
  • Ischemic Attack, Transient / etiology*
  • Ischemic Attack, Transient / mortality
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Phospholipases A2 / blood*
  • Prognosis
  • Proportional Hazards Models
  • Prospective Studies
  • Recurrence
  • Risk Assessment
  • Risk Factors
  • Spain
  • Stroke / blood
  • Stroke / diagnosis
  • Stroke / enzymology
  • Stroke / etiology*
  • Stroke / mortality
  • Time Factors

Substances

  • Biomarkers
  • Phospholipases A2
  • 1-Alkyl-2-acetylglycerophosphocholine Esterase
  • PLA2G7 protein, human