Circulating Levels of Secretory Type II Phospholipase A ₂ Predict Coronary Events in Patients with Coronary Artery Disease

TLDR

Secretory type II phospholipase A2 (sPLA₂) levels are elevated in chronic inflammatory diseases and are highly expressed in atherosclerotic arterial walls, suggesting a role in atherogenesis. This prospective study evaluated whether circulating sPLA₂ levels predict risk and prognosis in patients with coronary artery disease. Plasma sPLA₂ concentrations were quantified in 142 CAD patients and 93 controls using a radioimmunoassay. sPLA₂ levels correlated positively with C‑reactive protein and traditional risk factors, and concentrations above 246 ng/dL independently predicted the presence of CAD and future coronary events over two years, even after adjusting for CRP and other risk factors.

Abstract

Background —The circulating levels of secretory nonpancreatic type II phospholipase A 2 (sPLA 2 ) are increased in various chronic inflammatory diseases and the increase in the levels correlates with the disease severity. sPLA 2 may possibly play a role in atherogenesis and is highly expressed in atherosclerotic arterial walls that are known to have inflammatory features. Thus, this study prospectively examined whether circulating levels of sPLA 2 may have a significant risk and prognostic values in patients with coronary artery disease (CAD). Methods and Results —Plasma levels of sPLA 2 were measured in 142 patients with CAD and in 93 control subjects by a radioimmunoassay. The sPLA 2 levels had a significant and positive relations with serum levels of C-reactive protein, a marker of systemic inflammation, and with the number of the traditional coronary risk factors associated with individuals. Multivariate logistic regression analysis showed that higher levels of sPLA 2 (>246 ng/dL; 75th percentile of sPLA 2 distribution in controls) were a significant and independent risk factor for the presence of CAD. In multivariate Cox hazard analysis, the higher levels of sPLA 2 were a significant predictor of developing coronary events (ie, coronary revascularization, myocardial infarction, coronary death) during a 2-year follow-up period in patients with CAD independent of other risk factors, including CRP levels, an established inflammatory predictor. Conclusions —The increase in circulating levels of sPLA 2 is a significant risk factor for the presence of CAD and predicts clinical coronary events independent of other risk factors in patients with CAD; these results may reflect possible relation of sPLA 2 levels with inflammatory activity in atherosclerotic arteries.