Relationships Between Lipoprotein-associated Phospholipase A2and Coronary Artery Diseases As Well As The Prognosis

Objective:To explore the the relationships between LP-PLA2and the stability of coronary plaqueand the severity of coronary artery disease. To explore the relationships between LP-PLA2and other risk factors of coronary heart disease. And to explore the relationship between LP-PLA2and the prognosis of CHD.Methods:There were450people enrolled in the study from the second department of cardiology of Tianjin Chest Hospital from January to July of2012.There were390cases of CHD, including60cases of SAP,260cases of UAP,70cases of AMI,and cases of60Non-CHD.The biochemical indicators were collected,and the concentration of LP-PLA2was measured by ELISA. Through comparing the differences of LP-PLA2among the SAP,UAP and AMI,to explore the relationship between LP-PLA2and the stability of coronary plaque. Comparing the differences of LP-PLA2among the different number of vessals of the CHD, and the relationship between LP-PLA2and Gensini score, to explore the relationship between LP-PLA2and the severity of coronary artery disease. To explore the relationshipsbetween LP-PLA2and other risk factors of coronary heart disease by Person or Spearman correlation analysis. To follow up the incidences of MACE of the CHD for9to25months, including death, revascularization, angina and non-fatal myocardial infarction.RESULTS:1.The concentration of LP-PLA2of CHD was higher than that of non-CHD (264.85±89.13vs228.98±100.26, P<0.05).To look for an independent association of the occurrences of CHD with age,gender,and other risk factors,a multiple Logistic regression analysis was performed,and it showed that LP-PLA2, LP(a), BNP and male were the risk factors of CHD.2.There were no statistical differences of the concentration of LP-PLA2among SAP,UAP and AMI (228.98±89.13vs251.89±86.17vs267.47±102.48, F=0.971, P=0.380).3.The concentration of LP-PLA2of3vessels disease of coronary was higher than that of1vessel disease and2vessels disease,and the concentration of LP-PLA2of2 vessels disease of coronary was also higher than that of1vessel disease (247.46±100.56vs270.35±130.12vs292.58±114.67,F=3.127,P=0.043).And it was concluded that by Person correlation analysis the level of Lp-PLA2was positively correlated with the Gensini score (r=0.667,P=0.001).4.It was concluded that,by Person or Spearman correlation analysis, the level of Lp-PLA2was positively correlated with TC (r=0.339,P=0.000),and so was TG (r=0.240,P=0.000),LDL (r=0.382;P=0.000),VLDL (r=0.162,P=0.001),Apo-B (r=0.312,P=0.000),TBIL (r=0.138,P=0.004),CRP (r=0.139,P=0.007). And the level of Lp-PLA2was passively correlated with Apo-Al (r=-0.104,P=0.031). There was no significant correlationbetween the level of Lp-PLA2and BMI, BNP, FIB HBA1C,HDL,LP(a).5. To look for an independent association of the occurrences of MACE with age gender, and other risk factors, a multiple Cox regression analysis was performed And it showed that Gensini score and LP(a) were the risk factors of MACE.Conclusion:1. The concentration of LP-PLA2of CHD is higher than that of non-CHD. The multiple Logistic regression analysis indicates that LP-PLA2is a risk factor of the occurance of CHD.2. There are no statistical differences of the concentration of LP-PLA2among SAP,UAP and AMI. The concentration of LP-PLA2of3vessels disease of coronary is higher than that of1vessel disease and2vessels disease,and the concentration of LP-PLA2of2vessels disease of coronary is also higher than that of1vessel disease.And the level of Lp-PLA2is positively correlated with the Gensini score.It indicates that there is no significant correlation between LP-PLA2and the stability of coronary plaque,and LP-PLA2is correlated with the severity of coronary artery disease.3. The level of Lp-PLA2is positively correlated with TC, TG, LDL, VLDL, Apo-B, TBIL, and CRP. And the level of Lp-PLA2is passively correlated with Apo-Al. It indicates that LP-PLA2is associated with multiple risk factors of CHD, and it is an important risk factor of CHD.4. To look for an independent association of the occurrences of MACE with age,gender,and other risk factors,a multiple Cox regression analysis is performed.And it shows that Gensini score and LP(a) are risk factors of the occurance of MACE. There is no significant correlation between LP-PLA2and the occurrence of MACE.