on October 20, 2005
Published online before print October 20, 2005, doi: 10.1161/01.ATV.0000191655.87296.ab
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Submitted on July 19, 2005
Accepted on October 5, 2005
Lipoprotein-Associated Phospholipase A2 Is an Independent Marker for Coronary Endothelial Dysfunction in Humans
Eric H. Yang ;
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.
* To whom correspondence should be addressed. 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.
Key words: lipoprotein-associated phospholipase A2 • endothelial function • inflammatory markers
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