Relationship Between Lp-PLA₂ And Asymptomatic Severe Carotid Artery Stenosis And Dynamic Changes After Angioplasty

Objective 1.To investigate the correlation between Lp-PLA₂ and severe ACAS.2.To observe the dynamic changes of Lp-PLA₂ activity before and after carotid artery stenting.Method Accordance with the inclusion and exclusion criteria,patients who were to be diagnosed as severe ACAS by Department of Neurology and Department of neurointervention in the Affiliated Hospital of Qingdao University from June 2019 to January 2021 were recruited for cerebral angiography.According to the interventional measures for carotistenosisd artery treatment,the patients were divided into single angiography group（37 cases）,balloon dilatation group（28 cases）,stent group（54 cases）and control group（55 cases）totally 174 subjects were recruited in the research.Blood samples were collected in 24 hours after admission for plasma Lp-PLA₂ activity,high-density lipoprotein（HDL）,low-density lipoprotein（LDL）,high-sensitivity C-reactive protein（hs-CRP）,triglyceride（TG）as well as total cholesterol（TC）assessment;meanwhile,plasma Lp-PLA₂ activity was also detected at 2h,1d,3d and 15d after corresponding engagement in balloon dilatation group,simple angiography group and stent group.Logistic regression was employed to analyze all risk factors.Pearson correlation analysis and multiple linear regression model were used to analyze the relationship between Lp-PLA₂ activity and HDL,LDL,hs-CRP,TC as well as TG.The dynamic changes of Lp-PLA₂ in balloon dilation group,simple angiography group and stent group at different time points were analyzed by repeated measurement design analysis of variance.Results 1.Logistic regression showed that LDL,HDL,hs CRP and Lp-PLA₂ were all related to severe ACAS（P<0.05,OR=1.243,95%CI=1.082～1.539;P<0.05,OR=0.101,95%CI:0.051～0.603;P<0.05,OR=1.097,95%CI=1.011～1.401;P<0.05,OR=1.318,95%CI=1.102～1.804）.Pearson correlation analysis showed that Lp-PLA2activity was negative correlated to LDL（r=0.72;r=0;P<0.05）and hs-CRP（r=0.66;P<0.05）;63;r=-0.63;P<0.05).Multiple linear regression model showed that the beta values of LDL,HDL and hs CRP were 0.628（P<0.01）,-0.467（P<0.01）and 0.489（P<0.01）,respectively.2.Analysis of variance of repeated measurement design showed that the time effect,grouping effect and interaction effect of Lp-PLA₂ activity in stent group,simple angiography group and balloon dilation group were statistically significant（P<0.001）.Within 24 hours before operation,the activity of Lp-PLA₂ in stent group,simple angiography group and balloon dilation group was higher than that in control group（P<0.05）,in addition no significant difference was showed among the three groups（P>0.05）.Within 2 hours after operation,the stent group was higher than that of the balloon expansion group and the simple contrast group（P<0.05）,and there was no significant difference between the two groups（P>0.05）,Compared with before operation,the activity of Lp-PLA₂ in stent group and balloon dilation group increased within 2 hours after operation（P<0.05）,but there was no significant difference in angiography group（P>0.05）.Lp-PLA₂in stent group and balloon dilation group was higher than that in contrast group at 1 and 3days after operation（P<0.05）while no significant difference was showed between the two groups（P>0.05）;Compared with 2 hours after operation and pre-operation,the activity of Lp-PLA₂ in stent group and balloon dilation group was increased significantly（P<0.05）,however no significant difference was emerged in angiography group（P>0.05）.The activity of Lp-PLA₂ in stent group and balloon dilation group decreased 15 days after operation,but it was still higher than that in angiography group（P<0.05）;Compared with1 day,3 days and 2 hours after operation,the activity of Lp-PLA₂ in stent group,balloon dilation group and simple angiography group decreased apparently（P<0.05）;The activity of Lp-PLA₂ in stent group and balloon dilation group was lower than that before operation（P<0.05）.Conclusions The results indicated that 1.Lp-PLA₂ as an independent risk factor for severe ACAS;Lp-PLA₂ was positively correlated with LDL as well as hs CRP while negatively correlated with HDL.2.After carotid artery stenting for severe ACAS,the activity of Lp-PLA₂ showed temporary increased which was related to inflammation induced by destruction of atherosclerotic plaque.