Lipoprotein-Associated Phospholipase A₂: An Independent Predictor of Coronary Artery Disease Events in Primary and Secondary Prevention

Association of C-reactive protein (CRP) and lipoprotein-associated phospholipase A₂ (Lp-PLA₂) levels with the risk of a coronary event. In the case-cohort West of Scotland Coronary Prevention Study (WOSCOPS), both high-sensitivity CRP (hs-CRP) and Lp-PLA₂ were associated with coronary events in univariate analysis. After full adjustment for age, blood pressure, lipids, and other inflammatory markers, hs-CRP was no longer a significant predictor of coronary events. However, the significant association of Lp-PLA₂ with risk persisted in the fully adjusted model. BP = blood pressure. (Adapted from N Engl J Med.¹)

High levels of lipoprotein-associated phospholipase A₂ (Lp-PLA₂) and metabolic syndrome (MS): independent and additive risk factors. In the Malmö study comprising 4,480 patients without diabetes mellitus with 261 hard cardiovascular (CV) events over 10 years, Lp-PLA₂ activity was determined to be independent of and additive to insulin resistance–associated cardiovascular risk, a relatively unique characteristic compared with other inflammatory markers. (Adapted from Arterioscler Thromb Vasc Biol.³⁸)

Kaplan-Meier estimates of the incidence of the primary end point of death from any cause or a major cardiovascular event. Intensive lipid lowering with a 80-mg dose of atorvastatin compared with moderate lipid lowering with a 40-mg dose of pravastatin reduced the hazard ratio for death or a major cardiovascular event by 16%. No. = number. (Reprinted with permission from N Engl J Med.³⁸)

The Langzeiterfolge der Kardiologischen Anschlussheil-Behandlung (KAROLA) study: cardiovascular event-free survival with optimal low-density lipoprotein levels of 100 mg/dL (1 mg/dL = 0.02586 mmol/L) by lipoprotein-associated phospholipase A₂ (Lp-PLA₂) tertiles. Kaplan-Meier estimate of secondary fatal and nonfatal cardiovascular disease events during follow-up (time = days) according to tertiles of Lp-PLA₂ mass at baseline. (Reprinted with permission from Arterioscler Thromb Vasc Biol.¹¹)