PMID- 37022507
OWN - NLM
STAT- MEDLINE
DCOM- 20230623
LR  - 20230623
IS  - 1573-742X (Electronic)
IS  - 0929-5305 (Linking)
VI  - 56
IP  - 1
DP  - 2023 Jul
TI  - Lipoprotein associated- phospholipase A2 in STEMI vs. NSTE-ACS patients: a marker 
      of cardiovascular atherosclerotic risk rather than thrombosis.
PG  - 37-44
LID - 10.1007/s11239-023-02801-1 [doi]
AB  - The precise role of Lipoprotein associated phospholipase A2 (Lp-PlA2) in the 
      pathogenesis of acute coronary syndromes (ACS) and in the prediction of future 
      cardiovascular events is still debated. So far, few data exist on the variations 
      of Lp-PlA2 activity in ACS and especially in NSTE-ACS vs. STEMI patients, where 
      thrombotic and atherosclerotic mechanisms could play a differential role. The aim 
      of the present study was, then, to compare Lp-PlA2 activity according to the type 
      of ACS presentation. METHODS: A consecutive cohort of patients undergoing 
      coronary angiography for acute coronary syndrome (ACS) were included and divided 
      according to presentation for non ST-segment elevation-ACS or ST-segment 
      elevation Myocardial Infarction (STEMI). Lp-PLA2 activity was assessed in blood 
      samples drawn at admission using the Diazyme Lp-PlA2 Activity Assay. RESULTS: We 
      included in our study 117 patients, of whom 31 (26.5%) presented with STEMI. 
      STEMI patients were significantly younger (p = 0.05), displayed a lower rate of 
      hypertension (p = 0.002), previous MI (p = 0.001) and PCI (p = 0.01) and used 
      less frequently statins (p = 0.01) and clopidogrel (p = 0.02). White blood cells 
      and admission glycemia were increased in STEMI (p = 0.001, respectively). The 
      prevalence and severity of CAD was not different according to ACS types, but for 
      a higher prevalence of thrombus (p < 0.001) and lower TIMI flow (p = 0.002) in 
      STEMI. The levels of Lp-PlA2 were significantly lower in STEMI as compared to 
      NSTE-ACS patients, (132 +/- 41.1 vs. 154.6 +/- 40.9 nmol/min/mL, p = 0.01). In fact, 
      the rate of patients with Lp-PlA2 above the median (148 nmol/min/mL) was 
      significantly lower in STEMI patients as compared to NSTE-ACS (32.3% vs. 57%, 
      p = 0.02, adjusted OR[95% CI] = 0.20[0.06-0.68], p = 0.010). Moreover, a direct 
      linear relationship was observed between Lp-PlA2 and LDL-C (r = 0.47, p < 0.001), 
      but not with inflammatory biomarkers. CONCLUSION: The present study shows that 
      among ACS patients, the levels of Lp-PlA2 are inversely associated with STEMI 
      presentation and thrombotic coronary occlusion, being instead increased in 
      NSTE-ACS patients, therefore potentially representing a marker of more aggressive 
      chronic cardiovascular disease with an increased risk of recurrent cardiovascular 
      events.
CI  - (c) 2023. The Author(s), under exclusive licence to Springer Science+Business 
      Media, LLC, part of Springer Nature.
FAU - Verdoia, Monica
AU  - Verdoia M
AUID- ORCID: 0000-0001-6506-8397
AD  - Division of Cardiology, Nuovo Ospedale degli Infermi, ASL Biella, Biella, Italy.
FAU - Rolla, Roberta
AU  - Rolla R
AD  - Clinical Chemistry, Azienda Ospedaliera-Universitaria "Maggiore della Carita", 
      Universit? del Piemonte Orientale, Novara, Italy.
FAU - Gioscia, Rocco
AU  - Gioscia R
AD  - Division of Cardiology, Nuovo Ospedale degli Infermi, ASL Biella, Biella, Italy.
FAU - Rognoni, Andrea
AU  - Rognoni A
AD  - Division of Cardiology, Nuovo Ospedale degli Infermi, ASL Biella, Biella, Italy.
FAU - De Luca, Giuseppe
AU  - De Luca G
AD  - Division of Cardiology, AOU "Policlinico G. Martino", Department of Clinical and 
      Experimental Medicine, University of Messina, Messina, Italy. 
      giuseppe.deluca@unime.it.
AD  - Division of Cardiology, Galeazzi-Sant'Ambrogio Hospital, Milan, Italy. 
      giuseppe.deluca@unime.it.
CN  - Novara Atherosclerosis Study Group (NAS)
LA  - eng
PT  - Journal Article
DEP - 20230406
PL  - Netherlands
TA  - J Thromb Thrombolysis
JT  - Journal of thrombosis and thrombolysis
JID - 9502018
RN  - EC 3.1.1.47 (1-Alkyl-2-acetylglycerophosphocholine Esterase)
RN  - 0 (Biomarkers)
RN  - 0 (Lipoproteins)
SB  - IM
MH  - Humans
MH  - *Acute Coronary Syndrome
MH  - *ST Elevation Myocardial Infarction/diagnosis
MH  - 1-Alkyl-2-acetylglycerophosphocholine Esterase
MH  - *Percutaneous Coronary Intervention
MH  - Biomarkers
MH  - *Thrombosis/diagnosis/etiology
MH  - Lipoproteins
OTO - NOTNLM
OT  - Acute Coronary Syndrome
OT  - Inflammation
OT  - Lipoprotein associated- phospholipase A2; Biomarkers
EDAT- 2023/04/07 06:00
MHDA- 2023/06/23 06:42
CRDT- 2023/04/06 11:21
PHST- 2023/03/25 00:00 [accepted]
PHST- 2023/06/23 06:42 [medline]
PHST- 2023/04/07 06:00 [pubmed]
PHST- 2023/04/06 11:21 [entrez]
AID - 10.1007/s11239-023-02801-1 [pii]
AID - 10.1007/s11239-023-02801-1 [doi]
PST - ppublish
SO  - J Thromb Thrombolysis. 2023 Jul;56(1):37-44. doi: 10.1007/s11239-023-02801-1. 
      Epub 2023 Apr 6.