Plasma lipoprotein-associated phospholipase A₂ mass is elevated in STEMI compared to non-STEMI patients but does not discriminate between myocardial infarction and non-cardiac chest pain

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• 作者：Robin P.F. Dullaart ; L. Joost van Pelt ; Arjan J. Kwakernaak ; Bert D. Dikkeschei ; Iwan C.C. van der Horst ; Ren¨¦ A. Tio
• 关键词：Acute coronary syndrome ; Atypical chest pain ; Lipoprotein-associated phospholipase A2 ; STEMI ; Non-STEMI
• 刊名：Clinica Chimica Acta
• 出版年：2013
• 出版时间：23 September, 2013
• 年：2013
• 卷：424
• 期：Complete
• 页码：136-140
• 全文大小：277 K

文摘

Background

Plasma lipoprotein-associated phospholipase A₂ (Lp-PLA₂) mass predicts future cardiovascular events in the non-acute setting. We tested the extent to which Lp-PLA₂ is elevated in patients with acute coronary syndrome.

Methods

<p>A total of 231 consecutive patients referred for acute chest pain participated. Of this number, 144 were diagnosed with myocardial infarction (MI; 100 were classified as MI with ST-elevation (STEMI) and 44 as MI without ST-elevation (non-STEMI)). Eighty-seven patients had non-cardiac chest pain. Plasma Lp-PLA₂ mass was measured using turbidimetric immunoassay.

Results

<p>Lp-PLA₂ mass was not different between MI patients and patients with non-cardiac chest pain (231 ¡À 72 ¦Ìg/l vs.243 ¡À 88 ¦Ìg/l, p = 0.29), and did not relate to MI in age- and sex-adjusted logistic regression analysis (odds ratio per SD increment, 0.92 (95 % CI, 0.69-1.23), p = 0.58). However, Lp-PLA₂ mass was elevated in STEMI compared to non-STEMI patients (246 ¡À 73 vs. 198 ¡À 58 ng/ml, p < 0.001), and independently predicted STEMI (odds ratio, 2.35 (95 % CI, 1.46-3.79), p < 0.001). Among MI patients maximal creatine kinase was correlated positively with Lp-PLA₂ (r = 0.183, p = 0.034).

Conclusions

<p>In the acute setting, plasma Lp-PLA₂ mass is not elevated in MI patients, although Lp-PLA₂ mass appears to relate to the severity of myocardial damage.