This Article Full Text Full Text (PDF) All Versions of this Article: 26/1/106    most recent 01.ATV.0000191655.87296.abv1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Yang, E. H. Articles by Lerman, A. Search for Related Content PubMed PubMed Citation Articles by Yang, E. H. Articles by Lerman, A. Related Collections Endothelium/vascular type/nitric oxide Risk Factors Related Article

(Arteriosclerosis, Thrombosis, and Vascular Biology. 2006;26:106.)
© 2006 American Heart Association, Inc.

Vascular Biology

Lipoprotein-Associated Phospholipase A₂ Is an Independent Marker for Coronary Endothelial Dysfunction in Humans

Eric H. Yang; Joseph P. McConnell; Ryan J. Lennon; Gregory W. Barsness; Geralyn Pumper; Stacy J. Hartman; Charanjit S. Rihal; Lilach O. Lerman; Amir Lerman

From the Division of Cardiovascular Diseases (E.H.Y., G.W.B., G.P., C.S.R., A.L.), Department of Laboratory Medicine and Pathology (J.P.M., S.J.H.), Division of Biostatistics (R.J.L.), and Division of Nephrology and Hypertension (L.O.L.), Mayo College of Medicine, Rochester, Minn.

Correspondence to Amir Lerman, MD, Division of Cardiovascular Disease and Internal Medicine, Mayo College of Medicine, 200 First St SW, Rochester, MN 55905. E-mail lerman.amir{at}mayo.edu

Objective— The purpose of the current study was to determine whether lipoprotein-associated phospholipase A₂ (Lp-PLA₂) is associated with coronary endothelial dysfunction and is a predictor of endothelial dysfunction in humans.

Methods and Results— Patients (172) with no significant coronary artery disease (<30% stenosis) undergoing assessment of coronary endothelial function were studied. Endothelial function was assessed by the change in coronary blood flow and coronary artery diameter in response to intracoronary acetylcholine. Plasma concentrations of Lp-PLA₂ were measured, and patients were divided into tertiles. Patients in tertiles 2 and 3 had a significantly lower change in coronary blood flow (63.8±73.2 and 32.0±71.7 versus 78.4±73.2%; P<0.001) and greater epicardial coronary artery vasoconstriction (–14.1±14.7 and –23.3±25.1 versus –9.5±15.2% mean diameter change; P<0.001) in response to acetylcholine. Patients with coronary endothelial dysfunction had significantly higher serum concentrations of Lp-PLA₂ than those with normal endothelial function (246.2±71.6 versus 209±56.7 ng/mL; P=0.001). The odds ratio for coronary endothelial dysfunction in patients with Lp-PLA₂ in the highest tertile was 3.3 (95% CI, 1.6 to 6.6).

Conclusions— Lp-PLA₂ is independently associated with coronary artery endothelial dysfunction and is a strong predictor of endothelial dysfunction in humans.

Coronary endothelial dysfunction can be considered a marker for early atherosclerosis and has been shown to be associated with an increased risk of ischemic cardiac events and stroke. The results of the current study show that Lp-PLA₂, an enzyme involved in the metabolism of oxidized phospholipids, is independently associated with coronary artery endothelial dysfunction and is a strong predictor of endothelial dysfunction in humans.

Key Words: lipoprotein-associated phospholipase A₂ • endothelial function • inflammatory markers

Related Article:

Lipoprotein-Associated Phospholipase A₂ and Cardiovascular Risk: State of the Evidence and Future Directions

Carlos Iribarren
Arterioscler. Thromb. Vasc. Biol. 2006 26: 5-6. [Full Text] [PDF]

This article has been cited by other articles:

				D. Mannheim, J. Herrmann, D. Versari, M. Gossl, F. B. Meyer, J. P. McConnell, L. O. Lerman, and A. Lerman Enhanced Expression of Lp-PLA2 and Lysophosphatidylcholine in Symptomatic Carotid Atherosclerotic Plaques Stroke, May 1, 2008; 39(5): 1448 - 1455. [Abstract] [Full Text] [PDF]

				W. Koenig Treating Residual Cardiovascular Risk: Will Lipoprotein-Associated Phospholipase A2 Inhibition Live Up to Its Promise? J. Am. Coll. Cardiol., April 29, 2008; 51(17): 1642 - 1644. [Full Text] [PDF]

				L. B. Daniels, G. A. Laughlin, M. J. Sarno, R. Bettencourt, R. L. Wolfert, and E. Barrett-Connor Lipoprotein-associated phospholipase A2 is an independent predictor of incident coronary heart disease in an apparently healthy older population: the Rancho Bernardo Study. J. Am. Coll. Cardiol., March 4, 2008; 51(9): 913 - 919. [Abstract] [Full Text] [PDF]

				K. Winkler, M. M. Hoffmann, B. R. Winkelmann, I. Friedrich, G. Schafer, U. Seelhorst, B. Wellnitz, H. Wieland, B. O. Boehm, and W. Marz Lipoprotein-Associated Phospholipase A2 Predicts 5-Year Cardiac Mortality Independently of Established Risk Factors and Adds Prognostic Information in Patients with Low and Medium High-Sensitivity C-Reactive Protein (The Ludwigshafen Risk and Cardiovascular Health Study) Clin. Chem., August 1, 2007; 53(8): 1440 - 1447. [Abstract] [Full Text] [PDF]

				S. Lavi, J. P. McConnell, C. S. Rihal, A. Prasad, V. Mathew, L. O. Lerman, and A. Lerman Local Production of Lipoprotein-Associated Phospholipase A2 and Lysophosphatidylcholine in the Coronary Circulation: Association With Early Coronary Atherosclerosis and Endothelial Dysfunction in Humans Circulation, May 29, 2007; 115(21): 2715 - 2721. [Abstract] [Full Text] [PDF]

				S. Lavi, A. Prasad, E. H. Yang, V. Mathew, R. D. Simari, C. S. Rihal, L. O. Lerman, and A. Lerman Smoking Is Associated With Epicardial Coronary Endothelial Dysfunction and Elevated White Blood Cell Count in Patients With Chest Pain and Early Coronary Artery Disease Circulation, May 22, 2007; 115(20): 2621 - 2627. [Abstract] [Full Text] [PDF]

				Y. Gerber, J. P. McConnell, A. S. Jaffe, S. A. Weston, J. M. Killian, and V. L. Roger Lipoprotein-Associated Phospholipase A2 and Prognosis After Myocardial Infarction in the Community Arterioscler. Thromb. Vasc. Biol., November 1, 2006; 26(11): 2517 - 2522. [Abstract] [Full Text] [PDF]

				C. Iribarren Lipoprotein-Associated Phospholipase A2 and Cardiovascular Risk: State of the Evidence and Future Directions Arterioscler. Thromb. Vasc. Biol., January 1, 2006; 26(1): 5 - 6. [Full Text] [PDF]