(Circulation. 1999;100:1280-1284.)
© 1999 American Heart Association, Inc.
Clinical Investigation and Reports |
Circulating Levels of Secretory Type II Phospholipase A2 Predict Coronary Events in Patients with Coronary Artery Disease
From the Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan.
Correspondence to Kiyotaka Kugiyama, MD, PhD, Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Honjo 1-1-1, Kumamoto City, Japan 860-8556. E-mail kiyo{at}gpo.kumamoto-u.ac.jp
Background—The circulating levels of secretory nonpancreatic type II phospholipase A2 (sPLA2) are increased in various chronic inflammatory diseases and the increase in the levels correlates with the disease severity. sPLA2 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 sPLA2 may have a significant risk and prognostic values in patients with coronary artery disease (CAD).
Methods and Results—Plasma levels of sPLA2 were measured in 142 patients with CAD and in 93 control subjects by a radioimmunoassay. The sPLA2 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 sPLA2 (>246 ng/dL; 75th percentile of sPLA2 distribution in controls) were a significant and independent risk factor for the presence of CAD. In multivariate Cox hazard analysis, the higher levels of sPLA2 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 sPLA2 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 sPLA2 levels with inflammatory activity in atherosclerotic arteries.
Key Words: atherosclerosis • coronary disease • lipids • prognosis • risk factors
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