Lipoprotein-Associated Phospholipase A2 Activity Is Associated with Large-Artery Atherosclerotic Etiology and Recurrent Stroke in TIA Patients
Lipoprotein-Associated Phospholipase A2 Activity Is Associated with Large-Artery Atherosclerotic Etiology and Recurrent Stroke in TIA Patients
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DOI：
10.1159/000334193
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发表时间：
2012-01-01
影响因子：
2.9
通讯作者：
Montaner, Joan
中科院分区：
文献类型：
--
作者：
Delgado, Pilar;Chacon, Pilar;Montaner, Joan
背景：脂蛋白相关磷脂酶A(2)(Lp-PLA(2))作为一种新的心血管疾病生物标志物，在基于人群的研究中因其预测中风的能力而出现。本研究旨在探讨短暂性脑缺血发作(TIA)患者血浆脂蛋白-聚乳酸(2)水平及其与卒中复发的关系。方法：对166例短暂性脑缺血发作(TIA)患者和144例健康体检者分别用OLYMPUS全自动生化分析仪和比色法(DIADXUS)测定Lp-PLA2的质量和活性。评估血管危险因素和卒中病因。结果被定义为在TIA指数后7天和30天内出现复发的中风/TIA。进行多变量分析以确定复发的潜在预测因素。结果：短暂性脑缺血发作患者Lp-PLA(2)质量和活性均高于对照组(P<0.05)。多个危险因素或既往治疗与LP-PLA(2)质量和活动水平相关。在随访期间，前30天内发生20次卒中/短暂性脑缺血发作(12%)，卒中大动脉粥样硬化病因(Hr3.28，p=0.011)，既往高脂血症病史(Hr3.68，p=0.008)和脂蛋白-磷脂酶A(2)活性(Hr2.7，p=0.042)都是复发卒中/短暂性脑缺血发作的显著预测因素。结论：Lp-pla(2)活性对TIA患者的早期评估有重要的预后意义。版权所有(C)2011 S.Karger AG，巴塞尔
Background: Lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) has emerged as a novel biomarker in cardiovascular diseases due to its ability to predict stroke in population-based studies. We aimed to investigate Lp-PLA(2) levels in transient ischemic attack (TIA) patients and to study their relationship with stroke recurrence. Methods: Lp-PLA(2) mass and activity were measured by means of the PLAC test with an automated Olympus analyzer and by a colorimetric activity method (diaDexus) in 166 TIA patients and 144 healthy controls. Vascular risk factors and stroke etiology were assessed. Outcome was defined as the presence of recurrent stroke/TIA within 7 and 30 days after the index TIA. Multivariate analyses were performed to identify potential predictors of recurrence. Results: Both Lp-PLA(2) mass and activity (p < 0.05) were higher in TIA than in controls. Several risk factors or previous treatments were associated with Lp-PLA(2) mass and activity level. During follow-up, 20 strokes/TIA (12%) occurred within the first 30 days and the presence of a large-artery atherosclerosis etiology of stroke (HR 3.28, p = 0.011), together with the past medical history of hyperlipidemia (HR 3.68, p = 0.008) and Lp-PLA(2) activity of >207 nmol/ml/min (HR 2.7, p = 0.042) were all significant predictors for recurrent stroke/TIA. Conclusions: Lp-PLA(2) activity might add significant prognostic information in the early evaluation of TIA patients. Copyright (C) 2011 S. Karger AG, Basel