Lipoprotein-associated phospholipase A2 as a biomarker for coronary disease and stroke

Caslake, M.J. and Packard, C.J. (2005) Lipoprotein-associated phospholipase A2 as a biomarker for coronary disease and stroke. Nature Clinical Practice Cardiovascular Medicine, 2(10), pp. 529-535. (doi: 10.1038/ncpcardio0321)

Abstract

Lipoprotein-associated phospholipase A2 (Lp-PLA2), also known as platelet-activating factor acetylhydrolase, is a plasma enzyme that circulates bound to lipoproteins. The association between Lp-PLA2 and atherosclerosis is ambiguous, as it can both degrade and generate potentially damaging vasoactive molecules. In this article, we speculate that Lp-PLA2 associated with HDL might have cardioprotective properties, whereas the same enzyme bound to LDL might contribute directly to atherosclerosis at all stages, from lipoprotein oxidation to endothelial dysfunction, and plaque initiation and growth. Genetic and animal model studies give varying indications as to the contribution of Lp-PLA2 to atherogenesis and tend to support the view that higher Lp-PLA2 levels are cardioprotective. By contrast, a series of population studies point clearly to a positive association between plasma Lp-PLA2 levels or activity levels and risk of coronary heart disease or stroke. Typically, people with Lp-PLA2 levels in the highest quintile of the population have about a twofold greater risk than those in the lowest quintile. It is, perhaps, too early to introduce Lp-PLA2 as a population-wide biomarker for coronary heart disease risk; however, with accumulating evidence, it might find a place in a stepwise risk assessment of individuals who require more aggressive intervention to prevent vascular disease.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Caslake, Professor Muriel and Packard, Professor Chris
• Authors: Caslake, M.J., and Packard, C.J.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences
• Journal Name: Nature Clinical Practice Cardiovascular Medicine
• ISSN: 1743-4297