| Objective: To investigate the relevance between lipoprotein-associated phospholipase A2 (Lp-PLA2) and coronary heart disease (CHD), Lp-PLA2 activity with severity of coronary atherosclerosis, other established cardiovascular risk factors.And to observe the changes of Lp-PLA2 activity after percutaneous coronary intervention (PCI).Methods: Coronary angiography (CAG) was performed in 63 hospitalized patients who were suspected as having coronary heart disease. The severity of pathological changes of the coronary artery was assessed by the number of diseased coronary branches and Gensini's score. According to the results of CAG, 63 patients were divided into 2 groups: CHD group (cases, n =43) and non-CHD group (controls, n = 20). The CHD group patients were further divided into subgroups according to the clinical types, the number of diseased coronary branches and Gensini′s score.All blood samples were collected before medication and CAG, and the plasma Lp-PLA2 activity, Fibrinogen (Fbg), C-reactive protein (CRP), white blood cell (WBC) count, lipids, blood pressure, body mass index (BMI), serum glucosis (SG) and insulin (IS) etc. were measured.The insulin sensitive index (ISI) was calculated. The plasma Lp-PLA2 activity after percutaneous coronary intervention was observed in different days. Lp-PLA2 activity, WBC count and CRP were compared statistically between the subgroups, and spearman correlation coefficients (rp) of Lp-PLA2 activity with WBC count, CRP and other cardiovascular risk factors were calculated. Different variables were examined by linear regression analysis and binary logistic regression analysis, standardized coefficients (Beta) and odds ratio (OR) was obtained.Results: (1). Plasma Lp-PLA2 activity in CHD patients was significantly higher than that in controls (P < 0.01). No significant difference was found in Lp-PLA2 activity between patients with unstable angina pectoris (UA) and stable angina pectoris (SA).Also, plasma Lp-PLA2 activity in myocardial infarction patients was significantly higher than in SA and UA patients(P < 0.01). (2).Lp-PLA2 activity increased with the increasing number of diseased coronary branches and Gensini′s score. Stastistical variance was done among different individuals in cases(P < 0.01).(3).The plasma Lp-PLA2 activity after PCI 1day and 3 days got even more higher than that before PCI(P<0.01). The plasma Lp-PLA2 activity after 10 days was significantly lower than pre-PCI, but was still to remain significantly higher than controls. (4).Plasma Lp-PLA2 activity was positively correlated with LDL-C level(rp=0.551,P<0.01),negatively correlated with HDL-C(rp = -0.545,P<0.01), and was slightly correlated with age(rp =0.143,P<0.05),but was not association with triglyeride (TG),Fbg,total cholesterol(TC),BMI,WBC,CRP,ISI etc.(P>0.05). (5)Linear regression analysis shows that Beta for LDL-C,HDL-C was 0.537(P<0.01),-0.469(P<0.01) respectively.(6).Binary logistic regression analysis shows that the odds ratio for CHD associated with increasing Lp-PLA2 activity was 1.593(95%CI 1.316 to 1.927,P<0.01),the odds ratio for HDL-C,LDL-C and age respectively was 0.063(95%CI 0.006 to 0.606,P<0.01),1.177(95%CI 0.994 to 1.318,P<0.01),1.061(95%CI 1.038 to 1.085,P<0.01).Conclusions: (1).Plasma Lp-PLA2 activity in CHD patients was higher obviously than controls. (2).The severity of coronary atherosclerosis can be reflected by plasma Lp-PLA2 activity. (3).PCI possibly can induce increasing of Lp-PLA2 activity. (4).Lp-PLA2 activity was positively correlated with LDL-C,negatively correlated with HDL-C, and was slightly correlated with age, but was not association with TG,Fbg,BMI,WBC,CRP etc.(5).Both LDL-C and HDL-C have influence to Lp-PLA2 activity, and LDL-C was the most obviously. (6).Plasma Lp-PLA2 was a cardiovascular risk factor independently of other risk factors, which can be used as a parameter to predict CHD risk, and Lp-PLA2 may provide a new target for the treatment of CHD. |
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