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Lipoprotein-Associated Phospholipase A2: A Risk Factor for Ischemic Stroke?

Year 2018, Volume: 17 Issue: 2, 28 - 35, 30.12.2018

Abstract




Aim: The aim of the study is to investigate whether
there is an association between lipoprotein associated phospholipase A2 (Lp-PLA2)
and stroke ocurrence.




Methods: Fifty-two patients with acute ischemic stroke
within the 24 hours of the event and age and gender matched 42 control subjects
were enrolled to the study. This is a randomised, case-controlled, observational
study, involving patients and control subjects admitted to the Neurology Department
of Ankara Numune Education and Research Hospital between December 2009 and May 2010.




Results: The mean Lp-PLA2 level was 207.3±107.3
ng/ml in the patient group, and 128.6±10.3 ng/ml in
controls. The difference between patients and control groups were statistically
significant (p<0.01).




Conclusion: The results of our study revealed that
Lp-PLA2 plays a role in ischemic stroke and can be considered as an early
indicator for atherosclerosis. There is still need for new comprehensive
studies with larger patient groups in order to elucidate an accurate deduction.




Keywords: Atherosclerosis,  ischemic stroke, lipoprotein-associated phospholipase
A2, risk factors
.




References

  • [1] W. Rosamond, K. Flegal, G. Friday, K. Furie, A. Go, K. Greenlund, N. Haase, M. Ho, V. Howard, B. Kissela, S. Kittner, D. Lloyd-Jones, M. McDermott, J. Meigs, C. Moy, G. Nichol, C. J. O'Donnell, V. Roger, J. Rumsfeld, P. Sorlie, J. Steinberger, T. Thom, S. Wasserthiel-Smoller, Y. Hong, C. American Heart Association Statistics, and S. Stroke Statistics, "Heart disease and stroke statistics--2007 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee," Circulation, vol. 115, no. 5, pp. e69-171, Feb 6 2007.[2] P. Libby, "Inflammation in atherosclerosis," Nature, vol. 420, no. 6917, pp. 868-74, Dec 19-26 2002.[3] J. P. McConnell and D. M. Hoefner, "Lipoprotein-associated phospholipase A2," Clin Lab Med, vol. 26, no. 3, pp. 679-97, vii, Sep 2006.[4] N. Dada, N. W. Kim, and R. L. Wolfert, "Lp-PLA2: an emerging biomarker of coronary heart disease," Expert Rev Mol Diagn, vol. 2, no. 1, pp. 17-22, Jan 2002.[5] F. D. Kolodgie, A. P. Burke, K. S. Skorija, E. Ladich, R. Kutys, A. T. Makuria, and R. Virmani, "Lipoprotein-associated phospholipase A2 protein expression in the natural progression of human coronary atherosclerosis," Arterioscler Thromb Vasc Biol, vol. 26, no. 11, pp. 2523-9, Nov 2006.[6] C. H. MacPhee, K. E. Moores, H. F. Boyd, D. Dhanak, R. J. Ife, C. A. Leach, D. S. Leake, K. J. Milliner, R. A. Patterson, K. E. Suckling, D. G. Tew, and D. M. Hickey, "Lipoprotein-associated phospholipase A2, platelet-activating factor acetylhydrolase, generates two bioactive products during the oxidation of low-density lipoprotein: use of a novel inhibitor," Biochem J, vol. 338 ( Pt 2), pp. 479-87, Mar 1 1999.[7] C. H. Macphee, "Lipoprotein-associated phospholipase A2: a potential new risk factor for coronary artery disease and a therapeutic target," Curr Opin Pharmacol, vol. 1, no. 2, pp. 121-5, Apr 2001.[8] D. Li, W. Wei, X. Ran, J. Yu, H. Li, L. Zhao, H. Zeng, Y. Cao, Z. Zeng, and Z. Wan, "Lipoprotein-associated phospholipase A2 and risks of coronary heart disease and ischemic stroke in the general population: A systematic review and meta-analysis," Clin Chim Acta, vol. 471, pp. 38-45, Aug 2017.[9] H. H. Oei, I. M. van der Meer, A. Hofman, P. J. Koudstaal, T. Stijnen, M. M. Breteler, and J. C. Witteman, "Lipoprotein-associated phospholipase A2 activity is associated with risk of coronary heart disease and ischemic stroke: the Rotterdam Study," Circulation, vol. 111, no. 5, pp. 570-5, Feb 8 2005.[10] S. Lavi, J. Herrmann, R. Lavi, J. P. McConnell, L. O. Lerman, and A. Lerman, "Role of lipoprotein-associated phospholipase A2 in atherosclerosis," Curr Atheroscler Rep, vol. 10, no. 3, pp. 230-5, Jun 2008.[11] M. S. Elkind, W. Tai, K. Coates, M. C. Paik, and R. L. Sacco, "High-sensitivity C-reactive protein, lipoprotein-associated phospholipase A2, and outcome after ischemic stroke," Arch Intern Med, vol. 166, no. 19, pp. 2073-80, Oct 23 2006.[12] S. Wassertheil-Smoller, C. Kooperberg, A. P. McGinn, R. C. Kaplan, J. Hsia, S. L. Hendrix, J. E. Manson, J. S. Berger, L. H. Kuller, M. A. Allison, and A. E. Baird, "Lipoprotein-associated phospholipase A2, hormone use, and the risk of ischemic stroke in postmenopausal women," Hypertension, vol. 51, no. 4, pp. 1115-22, Apr 2008.[13] C. M. Ballantyne, R. C. Hoogeveen, H. Bang, J. Coresh, A. R. Folsom, L. E. Chambless, M. Myerson, K. K. Wu, A. R. Sharrett, and E. Boerwinkle, "Lipoprotein-associated phospholipase A2, high-sensitivity C-reactive protein, and risk for incident ischemic stroke in middle-aged men and women in the Atherosclerosis Risk in Communities (ARIC) study," Arch Intern Med, vol. 165, no. 21, pp. 2479-84, Nov 28 2005.[14] M. S. Elkind, W. Tai, K. Coates, M. C. Paik, and R. L. Sacco, "Lipoprotein-associated phospholipase A2 activity and risk of recurrent stroke," Cerebrovasc Dis, vol. 27, no. 1, pp. 42-50, 2009.[15] Y. Tian, H. Jia, S. Li, Y. Wu, L. Guo, G. Tan, and B. Li, "The associations of stroke, transient ischemic attack, and/or stroke-related recurrent vascular events with Lipoprotein-associated phospholipase A2: A systematic review and meta-analysis," Medicine (Baltimore), vol. 96, no. 51, p. e9413, Dec 2017.[16] M. S. Sabatine, D. A. Morrow, M. O'Donoghue, K. A. Jablonksi, M. M. Rice, S. Solomon, Y. Rosenberg, M. J. Domanski, J. Hsia, and P. Investigators, "Prognostic utility of lipoprotein-associated phospholipase A2 for cardiovascular outcomes in patients with stable coronary artery disease," Arterioscler Thromb Vasc Biol, vol. 27, no. 11, pp. 2463-9, Nov 2007.[17] 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, vol. 51, no. 9, pp. 913-9, Mar 4 2008.[18] F. Zhou, Y. Liu, H. Shi, Q. Huang, and J. Zhou, "Relation between lipoprotein-associated phospholipase A2 mass and incident ischemic stroke severity," Neurol Sci, Jun 25 2018.[19] A. Massot, D. Pelegri, A. Penalba, J. Arenillas, C. Boada, D. Giralt, M. Ribo, C. A. Molina, A. Rosell, J. Alvarez-Sabin, P. Chacon, A. Rovira, P. Delgado, and J. Montaner, "Lipoprotein-associated phospholipase A2 testing usefulness among patients with symptomatic intracranial atherosclerotic disease," Atherosclerosis, vol. 218, no. 1, pp. 181-7, Sep 2011.[20] K. J. Colley, R. L. Wolfert, and M. E. Cobble, "Lipoprotein associated phospholipase A(2): role in atherosclerosis and utility as a biomarker for cardiovascular risk," EPMA J, vol. 2, no. 1, pp. 27-38, Mar 2011.[21] P. L. A. S. C. Lp, A. Thompson, P. Gao, L. Orfei, S. Watson, E. Di Angelantonio, S. Kaptoge, C. Ballantyne, C. P. Cannon, M. Criqui, M. Cushman, A. Hofman, C. Packard, S. G. Thompson, R. Collins, and J. Danesh, "Lipoprotein-associated phospholipase A(2) and risk of coronary disease, stroke, and mortality: collaborative analysis of 32 prospective studies," Lancet, vol. 375, no. 9725, pp. 1536-44, May 1 2010.[22] P. W. Serruys, H. M. Garcia-Garcia, P. Buszman, P. Erne, S. Verheye, M. Aschermann, H. Duckers, O. Bleie, D. Dudek, H. E. Botker, C. von Birgelen, D. D'Amico, T. Hutchinson, A. Zambanini, F. Mastik, G. A. van Es, A. F. van der Steen, D. G. Vince, P. Ganz, C. W. Hamm, W. Wijns, A. Zalewski, B. Integrated, and I. Imaging Study, "Effects of the direct lipoprotein-associated phospholipase A(2) inhibitor darapladib on human coronary atherosclerotic plaque," Circulation, vol. 118, no. 11, pp. 1172-82, Sep 9 2008.

Lipoprotein-İlişkili Fosfolipaz A2: İskemik İnme için bir Risk Faktörü mü?

Year 2018, Volume: 17 Issue: 2, 28 - 35, 30.12.2018

Abstract




Amaç: Çalışmanın amacı, lipoprotein
ile ilişkili fosfolipaz A2 (Lp-PLA2) ile inme oluşumu arasında bir ilişki olup
olmadığını araştırmaktır.




Yöntem: Çalışma kapsamında 24
saatiçerisinde akut iskemik inme teşhisi konmuş 53 hasta ile hasta grubu yaş ve
cinsiyetine uygun 42 kontrol denek incelendi. Bu araştırma Aralık 2009 ve Mayıs
2010 tarihleri ​​arasında Ankara Numune Eğitim ve Araştırma Hastanesi Nöroloji
Bölümüne başvuran hastaları ve kontrol konularını içeren randomize, vaka
kontrollü, gözlemsel bir çalışmadır.




Bulgular: Çalışmamızda, Lp-PLA2'nin ortalama 
düzeylerinin hasta grubunda 207.3 ± 107.3 ng/ml, kontrol grubunda ise
128.6 ± 10.3 ng/ml olduğu, hasta ve kontrol grubu arasındaki farkın ise
istatistiksel olarak anlamlı olduğu bulunmuştur (p <0.01).




Sonuç: Çalışmamızın sonuçları,
Lp-PLA2'nin iskemik inmede rol oynadığını ve ateroskleroz için erken bir
gösterge olarak değerlendirilebileceğini gösterdi. Kesin bir sonuca ulaşabilmek
için daha geniş hasta grupları ile kapsamlı çalışmalara ihtiyaç vardır.




References

  • [1] W. Rosamond, K. Flegal, G. Friday, K. Furie, A. Go, K. Greenlund, N. Haase, M. Ho, V. Howard, B. Kissela, S. Kittner, D. Lloyd-Jones, M. McDermott, J. Meigs, C. Moy, G. Nichol, C. J. O'Donnell, V. Roger, J. Rumsfeld, P. Sorlie, J. Steinberger, T. Thom, S. Wasserthiel-Smoller, Y. Hong, C. American Heart Association Statistics, and S. Stroke Statistics, "Heart disease and stroke statistics--2007 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee," Circulation, vol. 115, no. 5, pp. e69-171, Feb 6 2007.[2] P. Libby, "Inflammation in atherosclerosis," Nature, vol. 420, no. 6917, pp. 868-74, Dec 19-26 2002.[3] J. P. McConnell and D. M. Hoefner, "Lipoprotein-associated phospholipase A2," Clin Lab Med, vol. 26, no. 3, pp. 679-97, vii, Sep 2006.[4] N. Dada, N. W. Kim, and R. L. Wolfert, "Lp-PLA2: an emerging biomarker of coronary heart disease," Expert Rev Mol Diagn, vol. 2, no. 1, pp. 17-22, Jan 2002.[5] F. D. Kolodgie, A. P. Burke, K. S. Skorija, E. Ladich, R. Kutys, A. T. Makuria, and R. Virmani, "Lipoprotein-associated phospholipase A2 protein expression in the natural progression of human coronary atherosclerosis," Arterioscler Thromb Vasc Biol, vol. 26, no. 11, pp. 2523-9, Nov 2006.[6] C. H. MacPhee, K. E. Moores, H. F. Boyd, D. Dhanak, R. J. Ife, C. A. Leach, D. S. Leake, K. J. Milliner, R. A. Patterson, K. E. Suckling, D. G. Tew, and D. M. Hickey, "Lipoprotein-associated phospholipase A2, platelet-activating factor acetylhydrolase, generates two bioactive products during the oxidation of low-density lipoprotein: use of a novel inhibitor," Biochem J, vol. 338 ( Pt 2), pp. 479-87, Mar 1 1999.[7] C. H. Macphee, "Lipoprotein-associated phospholipase A2: a potential new risk factor for coronary artery disease and a therapeutic target," Curr Opin Pharmacol, vol. 1, no. 2, pp. 121-5, Apr 2001.[8] D. Li, W. Wei, X. Ran, J. Yu, H. Li, L. Zhao, H. Zeng, Y. Cao, Z. Zeng, and Z. Wan, "Lipoprotein-associated phospholipase A2 and risks of coronary heart disease and ischemic stroke in the general population: A systematic review and meta-analysis," Clin Chim Acta, vol. 471, pp. 38-45, Aug 2017.[9] H. H. Oei, I. M. van der Meer, A. Hofman, P. J. Koudstaal, T. Stijnen, M. M. Breteler, and J. C. Witteman, "Lipoprotein-associated phospholipase A2 activity is associated with risk of coronary heart disease and ischemic stroke: the Rotterdam Study," Circulation, vol. 111, no. 5, pp. 570-5, Feb 8 2005.[10] S. Lavi, J. Herrmann, R. Lavi, J. P. McConnell, L. O. Lerman, and A. Lerman, "Role of lipoprotein-associated phospholipase A2 in atherosclerosis," Curr Atheroscler Rep, vol. 10, no. 3, pp. 230-5, Jun 2008.[11] M. S. Elkind, W. Tai, K. Coates, M. C. Paik, and R. L. Sacco, "High-sensitivity C-reactive protein, lipoprotein-associated phospholipase A2, and outcome after ischemic stroke," Arch Intern Med, vol. 166, no. 19, pp. 2073-80, Oct 23 2006.[12] S. Wassertheil-Smoller, C. Kooperberg, A. P. McGinn, R. C. Kaplan, J. Hsia, S. L. Hendrix, J. E. Manson, J. S. Berger, L. H. Kuller, M. A. Allison, and A. E. Baird, "Lipoprotein-associated phospholipase A2, hormone use, and the risk of ischemic stroke in postmenopausal women," Hypertension, vol. 51, no. 4, pp. 1115-22, Apr 2008.[13] C. M. Ballantyne, R. C. Hoogeveen, H. Bang, J. Coresh, A. R. Folsom, L. E. Chambless, M. Myerson, K. K. Wu, A. R. Sharrett, and E. Boerwinkle, "Lipoprotein-associated phospholipase A2, high-sensitivity C-reactive protein, and risk for incident ischemic stroke in middle-aged men and women in the Atherosclerosis Risk in Communities (ARIC) study," Arch Intern Med, vol. 165, no. 21, pp. 2479-84, Nov 28 2005.[14] M. S. Elkind, W. Tai, K. Coates, M. C. Paik, and R. L. Sacco, "Lipoprotein-associated phospholipase A2 activity and risk of recurrent stroke," Cerebrovasc Dis, vol. 27, no. 1, pp. 42-50, 2009.[15] Y. Tian, H. Jia, S. Li, Y. Wu, L. Guo, G. Tan, and B. Li, "The associations of stroke, transient ischemic attack, and/or stroke-related recurrent vascular events with Lipoprotein-associated phospholipase A2: A systematic review and meta-analysis," Medicine (Baltimore), vol. 96, no. 51, p. e9413, Dec 2017.[16] M. S. Sabatine, D. A. Morrow, M. O'Donoghue, K. A. Jablonksi, M. M. Rice, S. Solomon, Y. Rosenberg, M. J. Domanski, J. Hsia, and P. Investigators, "Prognostic utility of lipoprotein-associated phospholipase A2 for cardiovascular outcomes in patients with stable coronary artery disease," Arterioscler Thromb Vasc Biol, vol. 27, no. 11, pp. 2463-9, Nov 2007.[17] 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, vol. 51, no. 9, pp. 913-9, Mar 4 2008.[18] F. Zhou, Y. Liu, H. Shi, Q. Huang, and J. Zhou, "Relation between lipoprotein-associated phospholipase A2 mass and incident ischemic stroke severity," Neurol Sci, Jun 25 2018.[19] A. Massot, D. Pelegri, A. Penalba, J. Arenillas, C. Boada, D. Giralt, M. Ribo, C. A. Molina, A. Rosell, J. Alvarez-Sabin, P. Chacon, A. Rovira, P. Delgado, and J. Montaner, "Lipoprotein-associated phospholipase A2 testing usefulness among patients with symptomatic intracranial atherosclerotic disease," Atherosclerosis, vol. 218, no. 1, pp. 181-7, Sep 2011.[20] K. J. Colley, R. L. Wolfert, and M. E. Cobble, "Lipoprotein associated phospholipase A(2): role in atherosclerosis and utility as a biomarker for cardiovascular risk," EPMA J, vol. 2, no. 1, pp. 27-38, Mar 2011.[21] P. L. A. S. C. Lp, A. Thompson, P. Gao, L. Orfei, S. Watson, E. Di Angelantonio, S. Kaptoge, C. Ballantyne, C. P. Cannon, M. Criqui, M. Cushman, A. Hofman, C. Packard, S. G. Thompson, R. Collins, and J. Danesh, "Lipoprotein-associated phospholipase A(2) and risk of coronary disease, stroke, and mortality: collaborative analysis of 32 prospective studies," Lancet, vol. 375, no. 9725, pp. 1536-44, May 1 2010.[22] P. W. Serruys, H. M. Garcia-Garcia, P. Buszman, P. Erne, S. Verheye, M. Aschermann, H. Duckers, O. Bleie, D. Dudek, H. E. Botker, C. von Birgelen, D. D'Amico, T. Hutchinson, A. Zambanini, F. Mastik, G. A. van Es, A. F. van der Steen, D. G. Vince, P. Ganz, C. W. Hamm, W. Wijns, A. Zalewski, B. Integrated, and I. Imaging Study, "Effects of the direct lipoprotein-associated phospholipase A(2) inhibitor darapladib on human coronary atherosclerotic plaque," Circulation, vol. 118, no. 11, pp. 1172-82, Sep 9 2008.
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Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Article
Authors

Berna Alkan

Semra Öztürk Mungan

Publication Date December 30, 2018
Submission Date December 24, 2018
Acceptance Date December 31, 2018
Published in Issue Year 2018 Volume: 17 Issue: 2

Cite

APA Alkan, B., & Öztürk Mungan, S. (2018). Lipoprotein-İlişkili Fosfolipaz A2: İskemik İnme için bir Risk Faktörü mü?. Ankara Sağlık Hizmetleri Dergisi, 17(2), 28-35.
AMA Alkan B, Öztürk Mungan S. Lipoprotein-İlişkili Fosfolipaz A2: İskemik İnme için bir Risk Faktörü mü?. ASHD. December 2018;17(2):28-35.
Chicago Alkan, Berna, and Semra Öztürk Mungan. “Lipoprotein-İlişkili Fosfolipaz A2: İskemik İnme için Bir Risk Faktörü mü?”. Ankara Sağlık Hizmetleri Dergisi 17, no. 2 (December 2018): 28-35.
EndNote Alkan B, Öztürk Mungan S (December 1, 2018) Lipoprotein-İlişkili Fosfolipaz A2: İskemik İnme için bir Risk Faktörü mü?. Ankara Sağlık Hizmetleri Dergisi 17 2 28–35.
IEEE B. Alkan and S. Öztürk Mungan, “Lipoprotein-İlişkili Fosfolipaz A2: İskemik İnme için bir Risk Faktörü mü?”, ASHD, vol. 17, no. 2, pp. 28–35, 2018.
ISNAD Alkan, Berna - Öztürk Mungan, Semra. “Lipoprotein-İlişkili Fosfolipaz A2: İskemik İnme için Bir Risk Faktörü mü?”. Ankara Sağlık Hizmetleri Dergisi 17/2 (December 2018), 28-35.
JAMA Alkan B, Öztürk Mungan S. Lipoprotein-İlişkili Fosfolipaz A2: İskemik İnme için bir Risk Faktörü mü?. ASHD. 2018;17:28–35.
MLA Alkan, Berna and Semra Öztürk Mungan. “Lipoprotein-İlişkili Fosfolipaz A2: İskemik İnme için Bir Risk Faktörü mü?”. Ankara Sağlık Hizmetleri Dergisi, vol. 17, no. 2, 2018, pp. 28-35.
Vancouver Alkan B, Öztürk Mungan S. Lipoprotein-İlişkili Fosfolipaz A2: İskemik İnme için bir Risk Faktörü mü?. ASHD. 2018;17(2):28-35.