Introduction: Since atherosclerosis is a generalized process that takes place simultaneously in many vascular beds, state of the carotid arteries is seen as a predictor of the risk of serious cardiovascular events (strokes, heart attacks). Lipoprotein-associated phospholipase A2 (Lp-PLA2) is specific for vascular inflammation, and informs inflammation in the atherosclerotic plaque and its degree of stability. Detection of relationship between Lp-PLA2 levels and the atherosclerotic plaque presence in carotid arteries would be an additional criterion to specify severity and progression of the atherosclerotic process.
Purpose: To evaluate Lp-PLA2 levels in association with carotid atherosclerosis in patients with coronary artery disease.
Methods: 136 patients with verified coronary artery disease (stable angina, functional class III) were examined (average age was 55,4±5,9). Depending on the presence or absence of atherosclerotic plaques in carotid arteries and their amounts, all patients were divided into 3 groups: 1 group (n=46) – patients without carotid atherosclerosis, 2 group (n=42) – patients with 1 atherosclerotic plaque in carotid arteries, 3 group (n=48) – patients with 2 and more atherosclerotic plaques in carotid arteries. Concentration of Lp-PLA2 was determined through the “PLAC” test, “DiaDexus” company, USA. Duplex scanning of carotid arteries performed by standart method on the “Sequoia-512” apparatus, “Acuson” company (USA).
Results: Average levels of Lp-PLA2 was significantly higher in patients with 2 and more atherosclerotic plaques in carotid arteries, than in patients without carotid atherosclerosis (p=0,001), as well as total cholesterol (p=0,001) and low-density lipoprotein cholesterol (LDL-C) levels (p=0,001). Such duplex scanning indicators as intima-media thickness in systole, intima-media thickness increasing, carotid stenosis degree, significantly different between groups with and without atherosclerotic plaques in carotid arteries (p=0,001, p=0,025 and p=0,001, respectively). Correlation analysis detect statistically significant positive correlations between Lp-PLA2 levels and total cholesterol (p=0,000, p=0,01, p=0,001, respectively); between Lp-PLA2 levels and LDL-C (p=0,000, p=0,03, p=0,000, respectively) in all 3 groups. Besides, it was determined that Lp-PLA2 levels positively correlates with intima-media thickness of carotid arteries increasing in patients of 2 and 3 groups (p=0,03 and p=0,000, respectively), which is not found in 1 group, where patients were without carotid atherosclerosis.
Conclusion: A significant relationship between elevated Lp-PLA2 and the degree of carotid stenosis, and increased levels of total cholesterol, LDL-C. Elevated levels of Lp-PLA2 in serum, combined with the presence of increasing the degree of carotid stenosis, levels of total cholesterol, LDL-C, can be considered as probable risk factor for cardiovascular events.