Cor Vasa 2011, 53(4-5):234-238 | DOI: 10.33678/cor.2011.052

Lipoprotein-associated phospholipase A2 (Lp-PLA2) as a marker of atherosclerotic activity and a potential therapeutic target

Helena Vaverková^*, David Karásek

III. interní klinika - nefrologická, revmatologická a endokrinologická, Lékařská fakulta Univerzity Palackého v Olomouci a Fakultní nemocnice Olomouc, Olomouc, Česká republika

Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a vessel-specific inflammatory enzyme playing a role in the formation of vulnerable, rupture-prone atherosclerotic plaques. Lp-PLA2 is believed to be a link between oxidative LDL modification and the inflammatory response by the arterial intima. Unlike high-sensitivity C-reactive protein (hs-CRP) and other inflammatory markers produced by the liver, Lp-PLA2 is not associated with BMI, shows substantially lower intra-individual variability and is more vessel-specific. Prospective primary and secondary prevention studies have shown Lp-PLA2 potential to predict coronary events and ischemic stroke even after adjustment to conventional risk factors and hs-CRP. It is for these reasons that this novel marker of inflammation could become an invaluable surrogate marker of increased cardiovascular risk, in particular in individuals at intermediate risk not indicated (by current guidelines) for adequate modification of conventional risk factors, in particular hyperlipidemia.
Lp-PLA2 levels are decreased both by lifestyle modifications and most lipid-lowering agents. Darapladib, a selective Lp-PLA2 activity inhibitor, is currently being tested in a large morbi dity and mortality study STABILITY (Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy) which could potentially document the causative role of this novel risk factor in the process of atherosclerosis.

Keywords: Lipoprotein-associated phospholipase A2; Atherosclerosis; Lipoproteins; Cardiovascular risk; Darapladib

Published: April 1, 2011  Show citation