Can lipoprotein-associated phospholipase A2 be used as a predictor of long-term outcome in patients with acute coronary syndrome?
Can lipoprotein-associated phospholipase A2 be used as a predictor of long-term outcome in patients with acute coronary syndrome?
复制标题
DOI：
10.2174/1573403x09666131202143349
复制
发表时间：
2013-11
影响因子：
1.9
通讯作者：
Nybo M
中科院分区：
文献类型：
--
作者：
Holst-Albrechtsen S;Kjaergaard M;Huynh AN;Sorensen JK;Hosbond S;Nybo M
研究表明，血浆脂蛋白相关磷脂酶A2 （Lp-PLA2）浓度升高与心血管疾病风险增加有关。Lp-PLA2似乎在斑块和急性炎症的形成中起着至关重要的作用，因此血浆Lp-PLA2可能被用作ACS患者长期预后的预测因子。为了评估这一点，我们通过系统的文献综述收集了Lp-PLA2作为ACS患者预测因子的相关数据，并从PubMed和Cochrane等相关数据库中提取了相关研究。共检索到14篇文章，但经过全面评估和排除无关文章后，只有7篇研究符合文献综述的条件。除两项研究外，所有研究均显示Lp-PLA2与ACS患者CV事件有显著相关性。只有一项研究发现了ACS后30天CV事件的独立预测值。总之，关于Lp-PLA2的潜在用途的研究结果存在不一致，并且在几个问题上缺乏知识。Lp-PLA2似乎提供了ACS患者易发生新事件的有价值信息，也提供了斑块大小的重要信息。然而，需要对遗传变异、时间窗影响、有无心血管危险因素（如糖尿病）的患者和治疗效果进行更有针对性的研究。总之，Lp-PLA2为ACS的病理生理发展提供了新的见解，但在上述问题得到解决之前，该生物标志物将主要用于研究环境，而不是作为临床环境的预测参数。
Studies indicate that elevated plasma concentrations of lipoprotein-associated phospholipase A2 (Lp-PLA2) is associated with increased risk of cardiovascular disease. Lp-PLA2 seems to play a crucial role in the formation of plaques and acute inflammation, and plasma Lp-PLA2 could therefore potentially be used as a predictor of long-term outcome in ACS patients. To evaluate this, data concerning Lp-PLA2 as a predictor in ACS patients was gathered through a systematic literature review, and studies on this issue were extracted from relevant databases, incl. PubMed and Cochrane. A total of 14 articles were retrieved, but after thorough evaluation and elimination of irrelevant articles only seven studies were eligible for the literature review. All studies except two showed significant correlation between Lp-PLA2 and CV events in ACS patients. Only one study found an independent value to predict CV events 30 days after ACS. Altogether, there was inconsistency in the findings regarding the potential use of Lp-PLA2 and a lack of knowledge on several issues. Lp-PLA2 seems to give valuable information on which ACS patients are prone to new events and also provides important information on plaque size. However, more focused studies concerning genetic variations, time-window impact, patients with and without CV risk factors (e.g. diabetes), and treatment effects are needed. In conclusion, Lp-PLA2 offers new insight in the pathophysiological development of ACS, but until the aforementioned issues are addressed the biomarker will mainly be of interest in a research setting, not as a predictive parameter in a clinical setting.