Lipoprotein-Associated Phospholipase A2 Is Related to Plaque Stability and Is a Potential Biomarker for Acute Coronary Syndrome

Purpose: Plasma lipoprotein-associated phospholipase A(2) (Lp-PLA(2) ) binds to low-density lipoprotein. The levels of Lp-PLA(2) reflect the plaque burden, and are upregulated in acute coronary syndrome (ACS). We investigated the diagnostic value of Lp-PLA(2) levels and found that it might be a potential biomarker for ACS. Materials and Methods: We classified 226 study participants into three groups: patients without significant stenosis (control group), patients with significant stenosis with stable angina (SA group), and patients with ACS (ACS group). Results: Lp-PLA(2) and high-sensitivity C-reactive protein (is-CRP) levels were significantly greater in the ACS group than in the SA group (p=0.044 and p=0.029, respectively). Multivariate logistic regression analysis revealed that Lp-PLA(2) levels are significantly associated with ACS (odds ratio=1.047, p=0.013). The addition of Lp-PLA(2) to the ACS model significantly increased the global chi(2) value over traditional risk factors (28.14 to 35.602, p=0.006). The area under the receiver operating characteristic curve for Lp-PLA(2) was 0.624 (p=0.004). The addition of Lp-PLA(2) level to serum hs-CRP concentration yielded an integrated discrimination improvement of 0.0368 (p=0.0093, standard error: 0.0142) and improved the ability to diagnose ACS. Conclusion: Lp-PLA(2) levels are related to plaque stability and might be a diagnostic biomarker for ACS.