The Use Of Plasma Lipoprotein-associated Phospholipase A2 Levels In Risk Stratification And Prognostic Evaluation For Patients With Non-ST Elevation Acute Coronary Syndrome

ObjectiveTo study the plasma Lipoprotein-associated phospholipaseA2(LP-PLA2)level in evaluation of risk stratification and prognosis, in patients with non-ST elevation acute coronary syndromes (NSTE-ACS).MethodsFrom March 2009 to May 2010,128patients with NSTE-ACS who were examined by coronary angiography(CAG)were enrolled.128patients were divided into two groups:60cases were non-ST elevation myocardial infarction(NSTEMI)patients,68cases were unstable angina(UA),control group65cases.Then divide all NSTE-ACS patients into three groups according to TIMI score : high-score group 35cases,medium-score group49cases and low-score group 44 cases.All blood samples were collected before medication and CAG,and the plasma Lp-PLA2 mass,high sensitivity C-reactive protein(hs-CRP),white blood cell(WBC)count,lipids,blood pressure,body mass index(BMI),serum glucosis(SG)etc.were measured. Follow-up 30 days ,to observe the major cardiovascular events(death,heart failure,new happen angina and malignant arrhythmia).Results(1)LP-LA2 mass level in NSTE-ACS patients significantly higher than that in control group(P<0.01),the LP-LA2 mass in NSTEMI group and in UA group have no obvious difference(P>0.05) . (2) Groups divided by TIMI score:the LP-LA2 mass in high -score group was significantly higher than that both in medium-score group and low-score group (P<0.01) .But between medium-score group and low-score group ,the LP-LA2 mass have no significantly difference(P>0.05).(3)the LP-LA2 mass and LDL-C have a significantly positive correlation (rp=-0.298 P<0.01),TC also have positive correlation with LP-PLA2 mass.Other indicators (hs-CRP,age,TG and WBC )showed no obvious correlation with LP-PLA2 mass (P>0.05)(4)Follow-up 30 days,joint LP-PLA2 level and TIMI score,LP-PLA2 mass level in high-score group significantly higher than that both in medium-score group and low-score group(P<0.01),and NSTEMI patients with high-score have a higher incidence in composite cardiovascular events than that in medium-score group and low-score group(P<0.05).UA patients with high-score have a higher incidence in death that in medium-score group and low-score group(P<0.05). Conclusions(1)LP-LA2 mass level in NSTE-ACS patients significantly higher than that in control group,and it indicates that LP-LA2 mass level can be used in NSTE-ACS risk stratification.(2)LP-LA2 was an independent predictor in NSTE-ACS,and it independently of other traditional cardiovascular risk factors.(3)LP-PLA2 mass can be more meaningful in predicting the risk of coronary events and prognostic evaluation for NSTE-ACS patients .