Lipoprotein Associated Phospholipase A2 Activity and It’s Additive Value inCardiovascular Risk Stratification
Background: Lipoprotein associated phospholipase A2 (Lp-PLA2) has been known as a useful inflammatory marker of cardiovascular risk. Framingham score has also been widely used in long term cardiovascular risk stratification. However, it remain to be clarified whether increased Lp-PLA2 activity and Framingham score significantly increase odd ratio (OR) in acute myocardial infarction (AMI) setting. We therefore investigated Lp- PLA2 activity and it’s additive value for Framingham cardiovascular risk among myocardial infarction men.Blood samples were drawn from 60 men admitted to intensive care unit early after myocardial infarction and 40 healthy men with negative treadmill test as a control. Framingham score were calculated among all subjects. We measured Lp-PLA2 activity by ELISA. Lp-PLA2 activity was significantly higher in patients with myocardial infarction than those in control (83.97±27.15 nmol/ml/minute vs. 57.48±32.30 nmol/ml/minute; p=0.000). ROC analysis was performed to identify the most useful Lp-PLA2 cut-off level. Lp-PLA2 activity equal to or more than 74.21 nmol/ml/minute associated with myocardial infarction with accuracy 68%. The OR of AMI was increased by Lp-PLA2 activity added to Framingham score from 0.89(CI 95% 0.38- 2.11) to 4.48(CI 95% 1.90- 10.56) Conclusion: Addition of Lp-PLA2 activity to Framingham score may has additive predictive value in cardiovascular risk stratification.
Keywords: Lp-PLA2, myocardial infarction, cardiovascular risk stratification