The elevated lipoprotein-associated phospholipase A2 activity is associated with the occurrence and recurrence of acute cerebral infarction

Wei, Ling-li; Ke, Zunyu; Zhang, Yu; Zhang, Cai

doi:10.1097/wnr.0000000000000765

Cited by 24 publications

(14 citation statements)

References 35 publications

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“…The largest study tested 14 different biomarkers [38], including interleukin 6 and CRP [39], and limited utility in stroke prediction was found. Osteopontin, neopterin and myeloperoxidase [40], as well as lipoprotein-associated phospholipase A2 [41], free fatty acid levels [42] and circulating endothelial progenitor cells [43], have all been tested as recurrent stroke predictors with positive results, whereas the data regarding soluble CD40 ligand are inconsistent [40,44]. Similar to MMP-7 in the present study, elevated lipoprotein (a) in patients with acute first ischaemic stroke [45] has been associated with a higher risk of combined recurrent cardiovascular events.…”

Section: Discussionmentioning

confidence: 99%

Elevated circulating metalloproteinase 7 predicts recurrent cardiovascular events in patients with carotid stenosis: a prospective cohort study

Pérez‐Fernández

Irimia

Rodríguez

et al. 2020

BMC Cardiovasc Disord

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Background: Major adverse cardiovascular events are the main cause of morbidity and mortality over the long term in patients undergoing carotid endarterectomy. There are few reports assessing the prognostic value of markers of inflammation in relation to the risk of cardiovascular disease after carotid endarterectomy. Here, we aimed to determine whether matrix metalloproteinases (MMP-1, MMP-2, MMP-7, MMP-9 and MMP-10), tissue inhibitor of MMPs (TIMP-1) and in vivo inflammation studied by 18 F-FDG-PET/CT predict recurrent cardiovascular events in patients with carotid stenosis who underwent endarterectomy. Methods: This prospective cohort study was carried out on 31 consecutive patients with symptomatic (23/31) or asymptomatic (8/31) severe (> 70%) carotid stenosis who were scheduled for carotid endarterectomy between July 2013 and March 2016. In addition, 26 healthy controls were included in the study. Plasma and serum samples were collected 2 days prior to surgery and tested for MMP-1, MMP-2, MMP-7, MMP-9, MMP-10, TIMP-1, high-density lipoprotein, low-density lipoprotein, high-sensitivity C-reactive protein and erythrocyte sedimentation rate. 18 F-FDG-PET/CT focusing on several territories' vascular wall metabolism was performed on 29 of the patients because of no presurgical availability in 2 symptomatic patients. Histological and immunohistochemical studies were performed with antibodies targeting MMP-10, MMP-9, TIMP-1 and CD68. Results: The patients with carotid stenosis had significantly more circulating MMP-1, MMP-7 and MMP-10 than the healthy controls. Intraplaque TIMP-1 was correlated with its plasma level (r = 0.42 P = .02) and with 18 F-FDG uptake (r = 0.38 P = .05). We did not find any correlation between circulating MMPs and in vivo carotid plaque metabolism assessed by 18 F-FDG-PET. After a median follow-up of 1077 days, 4 cerebrovascular, 7 cardiovascular and 11 peripheral vascular events requiring hospitalization were registered. Circulating MMP-7 was capable of predicting events over and above the traditional risk factors (HR = 1.15 P = .006). When the model was associated with the variables of interest, the risk predicted by 18 F-FDG-PET was not significant. Conclusions: Circulating MMP-7 may represent a novel marker for recurrent cardiovascular events in patients with moderate to severe carotid stenosis. MMP-7 may reflect the atherosclerotic burden but not plaque inflammation in this specific vascular territory.

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Section: Discussionmentioning

confidence: 99%

Elevated circulating metalloproteinase 7 predicts recurrent cardiovascular events in patients with carotid stenosis: a prospective cohort study

Pérez‐Fernández

Irimia

Rodríguez

et al. 2020

BMC Cardiovasc Disord

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“…Subsequently, more Lp‐PLA2 is produced in plaques and the vulnerability of plaques is increased, which promote plaque rupture and cause more Lp‐PLA2 to be released into circulation (Ye et al, ). It has been revealed in a study on ischemic stroke that (Wei, Ke, Zhao, & Cai, ) the plasma level of Lp‐PLA2 is significantly higher in the ischemic stroke group than in the control group, and the difference was statistically significant ( p < .05) and that this was more significant in patients with atherosclerotic stroke in the great arteries. Hence, this may also be a risk factor for the early deterioration of central nervous system function (Wang, Hu, et al, ).…”

Section: Discussionmentioning

confidence: 99%

Effects of dl‐3‐n‐butylphthalide on serum lipoprotein‐associated phospholipase A2 and hypersensitive C‐reactive protein levels in acute cerebral infarction

Zhang¹,

Dong²,

Liu³

et al. 2019

Brain and Behavior

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ObjectiveThis study aims to explore the curative effect of dl‐3‐n‐butylphthalide (NBP) on patients with acute cerebral infarction (ACI) and its effects on serum lipoprotein‐associated phospholipase A2 (Lp‐PLA2) and hypersensitive C‐reactive protein (hs‐CRP) levels.MethodsA total of 136 ACI patients treated in our hospital, who met the criteria, were selected and randomly divided into two groups: control group (n = 60, including 28 males and 32 females) and treatment group (n = 76, including 32 males and 44 females). Patients in the control group were treated with routine drug therapy, while patients in the treatment group were treated with NBP on this basis. A dose of 100 ml was administered by intravenous injection for 2 times/day, for 14 days. The curative effect was evaluated using the National Institute of Health Stroke Scale (NIHSS) and Barthel index (BI) self‐care ability. The levels of the two factors in serum were measured using enzyme‐linked immunosorbent assay, and the changes in levels of these two factors in serum at different time points before and after treatment were compared between the two groups.Results(a) Lp‐PLA2 and hs‐CRP levels in the treatment group after treatment were significantly lower than those before treatment and those in the control group after treatment (p < .05). (b) The NIHSS and BI scores in the treatment group were significantly lower after treatment than before treatment and those in the control group after treatment (p < .05).ConclusionDl‐3‐n‐butylphthalide can improve the expression of Lp‐PLA2 and hs‐CRP in serum in ACI patients. Furthermore, NBP has significant efficacy in inhibiting inflammation and improving neurological symptoms.

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“…Previous studies showed that elevated Lp‐PLA2 was strongly associated with acute ischemic stroke. In addition, the elevated Lp‐PLA2 levels may contribute toward both stroke occurrence and recurrence . Furthermore, the results of the investigation of large clinical samples show that higher levels of Lp‐PLA2 in the acute period are associated with increased short‐term risk of recurrent vascular events .…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the elevated Lp-PLA2 levels may contribute toward both stroke occurrence and recurrence. 29 Furthermore, the results of the investigation of large clinical samples show that higher levels of Lp-PLA2 in the acute period are associated with increased short-term risk of recurrent vascular events. 30 To our knowledge, atherosclerosis is a chronic inflammation associated with increased expression of the acute-phase isoforms of SAA.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of lipoprotein‐associated phospholipase A2, serum amyloid A, and fibrinogen as diagnostic biomarkers for patients with acute cerebral infarction

Liang

ShiChuan

De-tai

et al. 2019

Clinical Laboratory Analysis

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Objective The aim of this study was to explore the clinical values of combined detection of lipoprotein‐associated phospholipase A2 (Lp‐PLA2), serum amyloid A (SAA), and plasma fibrinogen (FIB) in the diagnosis of acute cerebral infarction (ACI). Methods A case‐control study including 100 hospitalized patients with ACI and 47 healthy controls was carried out. The level of Lp‐PLA2, SAA, and FIB was detected, respectively, and their clinical values were analyzed. Carotid lesions and neurological impairment were also analyzed in each patient. Results The level of Lp‐PLA2, SAA, and FIB in the ACI group was significantly higher than that of the controls, and the three biomarkers showed a significant positive correlation and were considered as risk factors for ACI. The area under the curve (AUC) for Lp‐PLA2, SAA, and FIB was 0.858, 0.743, and 0.672, respectively. When three biomarkers were used in combination, the AUC was 0.879. Compared with the other groups, the levels of three biomarkers in bilateral carotid plaque ACI group were all significantly higher. In addition, the level of Lp‐PLA2 and SAA in ACI patients with severe neurological impairment was also significantly higher than that of the mild‐to‐moderate group. Conclusion Lp‐PLA2 combined with SAA and FIB had a high clinical value for rapid diagnosis and prediction of ACI. These biomarkers were also significantly associated with the formation of bilateral carotid atherosclerotic plaques and the severe neurological impairment in ACI patients.

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The elevated lipoprotein-associated phospholipase A2 activity is associated with the occurrence and recurrence of acute cerebral infarction

Cited by 24 publications

References 35 publications

Elevated circulating metalloproteinase 7 predicts recurrent cardiovascular events in patients with carotid stenosis: a prospective cohort study

Elevated circulating metalloproteinase 7 predicts recurrent cardiovascular events in patients with carotid stenosis: a prospective cohort study

Effects of dl‐3‐n‐butylphthalide on serum lipoprotein‐associated phospholipase A2 and hypersensitive C‐reactive protein levels in acute cerebral infarction

Evaluation of lipoprotein‐associated phospholipase A2, serum amyloid A, and fibrinogen as diagnostic biomarkers for patients with acute cerebral infarction

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