Abstract 3531: Lipoprotein-associated Phospholipase A2 Mass Is Significantly Reduced In Dyslipidemic Patients Treated With Lifestyle Counseling And Combination Lipid Modifying Drug Therapy
Background: Lipoprotein-associated phospholipase A2 (Lp-PLA2) mass is a novel inflammatory biomarker and independent predictor for cardiovascular disease. In human blood, Lp-PLA2 is predominately associated with low-density lipoprotein (LDL). Thus, it is hypothesized that changes in Lp-PLA2 should mirror changes in levels of LDL. To our knowledge, no studies exist which have examined the efficacy of lifestyle intervention and lipid drug therapy on reducing levels of Lp-PLA2 while also determining the relationship between changes in LDL and Lp-PLA2. Therefore, the primary purpose of this study was to assess the ability of lifestyle and combination lipid drug therapy to reduce levels of Lp-PLA2 among patients treated for mixed dyslipidemia. The secondary purpose was to examine the relationship between changes observed in Lp-PLA2 and LDL cholesterol (LDL-C).
Methods: Thirty dyslipidemic patients who received lifestyle intervention and combination lipid altering drug therapy for an average period of 6 months were included in these analyses (mean age=60.9, 40% with stable angiographically established CAD, 40% metabolic syndrome, 70% male). Lifestyle intervention included diet and exercise counseling. Drug therapy included omega-3 fish oil, extended release niacin, colesevelam HCl and a fixed combination of 10 mg ezetimibe and 40 mg simvastatin. Measures of Lp-PLA2 were determined by an FDA approved ELISA assay (PLAC ™ test, diaDexus, Inc.), whereas LDL-C was calculated with the Friedewald equation using overnight fasting blood samples.
Results: The study revealed a 34% reduction in median Lp-PLA2 values (baseline 230.5 3 47.4 vs. post-treatment 151.0 ± 35.5 ng/mL; p<.01). Significant changes in mean LDL-C from baseline (129.2 ± 49.0 vs. post-treatment 66.2 ± 32.2 mg/dL; p<.01) was also observed. However, regression analysis revealed only a weak positive relationship between changes in LDL-C and Lp-PLA2 mass (R2 =0.29; p<.01).
Conclusion: Lp-PLA2 mass is significantly reduced with the use of lifestyle and combination lipid lowering drug therapy. Changes in Lp-PLA2 were only partially explained by the changes observed for LDL-C.