Relationship between lipoprotein associated phospholipase A2 or hs-CRP and acute coronary syndrome

  AIM   To investigate the relationship between serum lipoprotein associated phospholipase A2 (Lp-PLA2) level or high-sensitivity c-reactive protein (hs-CRP) and the severity of coronary artery stenosis in patients with acute coronary syndrome (ACS).

  METHODS   A total of 480 patients who had undergone coronary angiography in our hospital from June 2017 to October 2018 were enrolled into this study and analyzed retrospectively. Three hundred and seventy-three patients were diagnosed with ACS and they were divided into two groups according to the median of their Gensini score. The two groups were defined as mild lesions group and severe lesions group. Additional 107 non-CAD hospitalized patients were selected as the control group.

  RESULTS   Serum Lp-PLA2 and hs-CRP level in the ACS group were significantly higher than those in the control group and the differences were statistically significant (P<0.01). Serum Lp-PLA2 and hs-CRP levels in the severe lesion group were higher than those in the mild lesion group and the difference was statistically significant (P<0.01). The serum level of Lp-PLA2 and Gensini score in patients with acute coronary syndrome increased gradually with the increase of the number of lesions and the degree of lesions and the difference was significant (P<0.01). The correlation analysis showed that the levels of serum Lp-PLA2 and hs-CRP were significantly positively correlated with Gensini score. Multivariate logistic regression analysis indicated that the levels of serum Lp-PLA2 and hs-CRP were independent risk factors of ACS. The receiver operating characteristic curve showed that the area under the curve of Lp-PLA2 for the diagnosis of ACS was 0.836 (95% CI: 0.802~0.869). Lp-PLA2 predicted ACS with a sensitivity of 64.1% and specificity of 96.6%.

  CONCLUSION   The levels of serum Lp-PLA2 and hs-CRP are positively associated with the severity of coronary artery stenosis in ACS patients. The levels of serum Lp-PLA2 and hs-CRP are independent risk factors of severe ACS. Lp-PLA2 has a certain predictive value for ACS.