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Lipoprotein-associated phospholipase A2 as a biomarker for coronary disease and stroke

Nature Clinical Practice Cardiovascular Medicine volume 2, pages 529–535 (2005)Cite this article

Abstract

Lipoprotein-associated phospholipase A2 (Lp-PLA2), also known as platelet-activating factor acetylhydrolase, is a plasma enzyme that circulates bound to lipoproteins. The association between Lp-PLA2 and atherosclerosis is ambiguous, as it can both degrade and generate potentially damaging vasoactive molecules. In this article, we speculate that Lp-PLA2 associated with HDL might have cardioprotective properties, whereas the same enzyme bound to LDL might contribute directly to atherosclerosis at all stages, from lipoprotein oxidation to endothelial dysfunction, and plaque initiation and growth. Genetic and animal model studies give varying indications as to the contribution of Lp-PLA2 to atherogenesis and tend to support the view that higher Lp-PLA2 levels are cardioprotective. By contrast, a series of population studies point clearly to a positive association between plasma Lp-PLA2 levels or activity levels and risk of coronary heart disease or stroke. Typically, people with Lp-PLA2 levels in the highest quintile of the population have about a twofold greater risk than those in the lowest quintile. It is, perhaps, too early to introduce Lp-PLA2 as a population-wide biomarker for coronary heart disease risk; however, with accumulating evidence, it might find a place in a stepwise risk assessment of individuals who require more aggressive intervention to prevent vascular disease.

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Figure 1: Putative proatherogenic properties of lipoprotein-associated phospholipase A2.
Figure 2: Potential use of lipoprotein-associated phospholipase A2 in a stepwise approach to coronary risk assessment.

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Authors and Affiliations

  1. a Senior Research Fellow in the Department of Vascular Biochemistry at Glasgow University, UK

    Muriel J Caslake

  2. a Consultant Scientist at Glasgow Royal Infirmary and Professor of Vascular Biochemistry in the Department of Vascular Biochemistry at Glasgow University, UK

    Chris J Packard

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  1. Muriel J Caslake
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Correspondence to Muriel J Caslake.

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Caslake, M., Packard, C. Lipoprotein-associated phospholipase A2 as a biomarker for coronary disease and stroke. Nat Rev Cardiol 2, 529–535 (2005). https://doi.org/10.1038/ncpcardio0321

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