Cor Vasa 2011, 53(12):712-716 | DOI: 10.33678/cor.2011.175

Concentration of Lp-PLA2 in stable patients in secondary prevention after STEMI and dose-effect of statins on its values

Ilona Pařenicová¹, Krystýna Prymusová², Miroslava Beňovská³, Lucie Babušíková³, Jiří Jarkovský², Ludmila Dostálová¹, Lenka Kubková¹, Petr Lokaj¹, Petr Kala¹, Martin Poloczek¹, Ondřej Toman¹, Jindřich Špinar^1,5, Jiří Pařenica^1,5,*

¹ Interní kardiologická klinika, Lékařská fakulta Masarykovy Univerzity a Fakultní nemocnice Brno, Brno

² Kardiologické oddělení, Nemocnice Podlesí, a.s., Třinec

³ Oddělení klinické biochemie a hematologie, Fakultní nemocnice Brno, Brno

⁴ Institut biostatistiky a analýz, Lékařská a Přírodovědecká fakulta Masarykovy univerzity, Brno

⁵ Interní kardiologická klinika, Lékařská fakulta Masarykovy Univerzity a Fakultní nemocnice Brno, Brno, Česká republika

Background and aim: Phospholipase A2 associated with lipoprotein (Lp-PLA2) is a biomarker specific for a vascular inflammation. Lp-PLA2 hydrolyzes oxidized phosphatidylcholine and produces an effective pro-inflammatory mediators that facilitate formation of atherosclerotic plaque instability. Previous works demonstrated that elevated Lp-PLA2>200-235 μg/L is an independent predictor of increased cardiovascular risk even after adjustment for traditional risk factors. The goal of our work was to determine levels of Lp-PLA2 in a group of stable patients after STEMI and to assess the effect of increased doses of statins on levels of Lp-PLA2 in a part of the patients with its elevated value.

Methods: 186 stable patients after acute myocardial infarction were examined. The lipid spectrum and levels of Lp-PLA2 were evaluated. The statin therapy was intensified in the patients with Lp-PLA2>200 μg/L, and after 3 months the control of lipids and Lp-PLA2 was performed.

Results: 12 months after acute MI in the group of 186 patients there was achieved a total cholesterol < 4 mmol/L in 45% of the patients, LDL cholesterol < 2 mmol/L in 50% of the patients. The average value of Lp-PLA2 was 166±86 μg/L. The patients with LDL < 2 mmol/L had significantly lower levels of Lp-PLA2 (151±75 vs. 178±92 μg/L; P = 0.02). Total 20% of the patients had Lp-PLA2>200 μg/L, and in the group of patients with LDL-cholesterol < 2 mmol/L there were 14% of patients with high level of Lp-PLA2. There was found a significant decline in both total and LDL cholesterol and levels of Lp-PLA2 (286 vs. 229 μg/L; P = 0.02) after the increased dose of statins.

Conclusions: About 7% of stable patients after STEMI had elevated levels of Lp-PLA2, despite well-controlled LDL cholesterol. More intensive statin therapy led to a significant reduction in Lp-PLA2 in these patients.

Keywords: Lp-PLA2; Secondary prevention; Statins

Published: December 1, 2011  Show citation