Journal of Advances in Medicine and Medical Research

Aims: We investigated whether Lp-PLA₂ activity of blood samples collected 24 h after hospital admission could serve as a predictor of future cardiovascular events in Vietnamese patients with acute coronary syndrome (ACS). In addition, we correlated Lp-PLA₂ with common risk factors of ACS, such as age, HDL, diabetes, BMI, etc. and compared Lp-PLA₂ levels of ACS patients with those of a control group.

Methods and Results: Lp-PLA₂ activity was measured in serum collected in fasting state within 24 h of hospitalization in 293 ACS patients. The mean [SD] of Lp-PLA₂ activity (nmol/min/mL) was higher in ACS patients than in controls (212.7[57.8] versus 182.5[58], p<0.001), the mean difference was 14.2% of mean in ACS group. Both non-ST elevated myocardial infarction (NSTEMI) and STEMI had higher Lp-PLA₂ compared to unstable angina (UA) (p<0.017). The 3^rd tertile of Lp-PLA₂ had a strong correlation with MI (NSTEMI/STEMI) showing ORs of 3.65 and 3.98 in logistic regression analysis compared to the 2 lower tertiles. There were only two factors, Lp-PLA₂ and age, serving as best independent predictors for future CV events in multivariate HR analysis. However their effects strongly began to start around 50 days after acute phase of ACS. The future CV event rates had an increasing trend from 1^st to 3^rd tertile (p_trend=0.011). The HR between 2^nd to 1^st tertile was 1.71 (p=0.075). The 3^rd tertile had nearly a double of adjusted hazard ratio (HR) as 1.92 compared to the 1^st tertile (p=0.029). There was weak association of Lp-PLA₂ activity with risk factors of CV diseases.

Conclusion: Lp-PLA₂ in acute phase of ACS was different between 3 groups of ACS. Both Lp-PLA₂ and age were independent predictors for future cardiovascular events in ACS patients.