Can Lipoprotein-associated Phospholipase A 2 be Used as a Predictor of Long-term Outcome in Patients with Acute Coronary Syndrome?

Abstract

Studies indicate that elevated plasma concentrations of lipoprotein-associated phospholipase A 2 (Lp-PLA 2 ) is associated with increased risk of cardiovascular disease. Lp-PLA 2 seems to play a crucial role in the formation of plaques and acute inflammation, and plasma Lp-PLA 2 could therefore potentially be used as a predictor of long-term outcome in ACS patients. To evaluate this, data concerning Lp-PLA 2 as a predictor in ACS patients was gathered through a systematic literature review, and studies on this issue were extracted from relevant databases, incl. PubMed and Cochrane. A total of 14 articles were retrieved, but after thorough evaluation and elimination of irrelevant articles only seven studies were eligible for the literature review. All studies except two showed significant correlation between Lp-PLA 2 and CV events in ACS patients. Only one study found an independent value to predict CV events 30 days after ACS. Altogether, there was inconsistency in the findings regarding the potential use of Lp-PLA 2 and a lack of knowledge on several issues. Lp-PLA 2 seems to give valuable information on which ACS patients are prone to new events and also provides important information on plaque size. However, more focused studies concerning genetic variations, time-window impact, patients with and without CV risk factors (e.g. diabetes), and treatment effects are needed. In conclusion, Lp-PLA 2 offers new insight in the pathophysiological development of ACS, but until the aforementioned issues are addressed the biomarker will mainly be of interest in a research setting, not as a predictive parameter in a clinical setting. © 2013 Bentham Science Publishers.