Distribution of Lipoprotein‑Associated Phospholipase A2 in Czech Population and its interaction with conventional cardiovascular risk

Česká verzia

Authors: O. Mayer jr. ¹; J. Seidlerová ¹; P. Wohlfart ²; L. Trefil ³; J. Bruthans ⁴; J. Filipovský ¹; R. Cífková ²
Authors place of work: II. interní klinika Lékařské fakulty UK a FN Plzeň, přednosta prof. MU Dr. Jan Filipovský, CSc. ¹; Centrum kardiovaskulární prevence Thomayerovy nemocnice Praha, přednostka prof. MU Dr. Renata Cífková, CSc. ²; Ústav klinické biochemie a hematologie Lékařské fakulty UK a FN Plzeň, přednosta prof. MU Dr. Jaroslav Racek, DrSc. ³; Pracoviště preventivní kardiologie IKEM Praha, přednostka doc. MU Dr. Věra Adámková, CSc. ⁴
Published in the journal: Vnitř Lék 2013; 59(5): 344-351
Category: Original Contributions

Summary

Introduction:
Lipoprotein‑associated phospholipase A2 (Lp‑ PLA₂) represent new cardiovascular risk factor and potential treatment target. We aimed to analyze the epidemiological situation of this factor in Czech population.

Methods and Results:
The study population consisted from 1 962 subjects, a random samples of general population (postMONICA study), and from patients with manifest coronary or cerebrovascular disease (Czech samples of EUROASPIRE III survey). Lp‑ PLA₂ activity was estimated using commercial kits by diaDexus Inc. in frozen samples. Increased activity (by definition, i.e. > 195 nmol/ min/ ml) was observed in 21.1 % of sample, no apparent difference between subject with and without manifest vascular disease was found. Males showed higher Lp‑ PLA₂ activity, than females (179.6 vs 146, resp., p < 0.0001), while no substantial increase with age was observed. Taking Lp‑ PLA₂ activity > 195 as dependent variable, following independent variables entered the multiple logistic regression: male gender [with odds ratio 4.26 (3.26– 5.58)], low HDL‑cholesterol (i.e. < 1.0 mmol/ l in males or < 1.2 mmol/ l in females) [3.49 (2.62– 4.64)], LDL‑cholesterol > 2.5 mmol/ l [6.95 (4.79– 10.07)] and lipid‑ lowering treatment [0.59 (0.44– 0.79)]. In subject without manifest vascular disease, 6.3 % of them showed co‑ incidence of markedly increased Lp‑ PLA₂ activity with high conventional risk (SCORE > 10 %). Expanding this group by intermediate risk subjects (ie. with Lp‑ PLA₂ activity 152– 194 and/ or SCORE 5– 9.9 %) leads to increase of this prevalence to 28.9 % of primary prevention subjects.

Conclusion:
Increased Lp‑ PLA₂ activity is in Czech population highly prevalent and with exception of lipid parameters, generally independent from conventional cardiovascular risk. However, up to 29 % of subject in primary prevention amalgamate increased Lp‑ PLA₂ activity with high conventional cardiovascular risk.

Key words:
lipoprotein – associated phospholipase A2 – primary prevention – secondary prevention – epidemiology

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