The associations of stroke, transient ischemic attack, and/or stroke-related recurrent vascular events with Lipoprotein-associated phospholipase A2

Abstract

Background:Studies on stroke and lipoprotein-associated phospholipase A2 (Lp-PLA2) have produced conflicting results.Objective:The aim of the study was to assess the associations of Lp-PLA2 levels (mass and activity) with recurrent vascular events in patients with transient ischemic attack (TIA) and/or first ischemic stroke and with stroke in the general population.Methods:The MEDLINE, Embase, the Cochrane Library, Web of Science, Science Direct, China National Knowledge Infrastructure, China Biology Medical Disc (CBMdisc), and WanFang were searched for prospective observational studies reported until January 2017. Eligible studies reported Lp-PLA2 levels and adjusted risk estimates of recurrent vascular events and/or stroke. Risk ratio (RR) with corresponding 95% confidence intervals (CIs) were used to express the pooled data in a random-effects model.Results:A total of 11 studies that comprised 20,284 participants (4,045 were TIA and/or first ischemic stroke patients and 16,239 were residents in general population) were identified, which reported either Lp-PLA2 mass levels (4 studies) or Lp-PLA2 activity levels (10 studies). The pooled RR of recurrent vascular events (467 cases) in TIA and/or first ischemic group was 2.24 (95% CI, 1.33–3.78), whereas the pooled RR of stroke (1604 cases) in the general population was 1.47 (95% CI, 1.10–1.97). The pooled RRs of Lp-PLA2 mass and activity levels with the risk of stroke in the general population were 1.69 (95% CI, 1.03–2.79) and 1.28 (95% CI, 0.88–1.85), respectively.Conclusions:In patients with TIA and first ischemic stroke, elevated Lp-PLA2 activity levels were associated with recurrent vascular events. And in the general population elevated Lp-PLA2 levels were associated with the risk of stroke, although the association between Lp-PLA2 activity levels and the risk of stroke was less profound compared with the corresponding association of stroke risk with the Lp-PLA2 mass levels.

Effects of Cervical Rotatory Manipulation (CRM) on Carotid Atherosclerosis Plaque in Vulnerability: A Histological and Immunohistochemical Study Using Animal Model

“…Lp-PLA2 is produced by macrophages and foam cells in the vascular intima in atherosclerotic plaque, and its biology is linked to the causal pathway of plaque inflammation and ultimate rupture. The serum levels of hs-CRP and Lp-PLA2 are not only risk predictors, but also the key in risk-guided therapy of atherosclerosis diseases [43–46]. This study found that the main effects of CAS modeling on the serum levels of hs-CRP and Lp-PLA2 were significant.…”

Lipoprotein-Associated Phospholipase A2 is Linked with Poor Cardio-Metabolic Profile in Patients with Ischemic Stroke: A Study of Effects of Statins

“…Interestingly, Lp-PLA2 mass serum levels in the present study were high in stroke patients compared to the controls as demonstrated by recent Tian et al ., a study that showed the association between high, Lp-PLA2 mass serum levels but not Lp-PLA2 activity with the SR.[ 35 ] This is the main reason for selection of Lp-PLA2 mass serum levels but not Lp-PLA2 activity in the present study to evaluate the potential inflammatory role in the ischemic stroke as Lp-PLA2 mass serum levels showed less time-dependent biological variability compared to Lp-PLA2 activity. Moreover, levels of Lp-PLA2 activity are linked with TIA and complicated vascular events whereas; Lp-PLA2 mass levels are more specific and accurate than Lp-PLA2 activity in the association with SR in general populations.…”

Phospholipase A2 is an Inflammatory Predictor in Cardiovascular Diseases: Is there any Spacious Room to Prove the Causation?

“…Also, in the general population, high plasma Lp-PLA 2 levels are related to the risk of stroke [ 32 ]. While a higher Lp-PLA 2 activity is related to an enhanced risk for incident PAD, it is more likely that traditional CVD risk factors are more causative [ 7 ].…”