Abstract 21315: Serum Spla2 Activity, Spla2-IIa Mass and Oxldl Levels Are Related to the Significance of the Coronary Stenosis in Patients With Stable Coronary Artery Disease
Background: Biomarkers involved in generation of modified lipoproteins have been associated with increased risk of cardiovascular morbidity/mortality. We sought to determine whether elevated levels of sPLA2 activity, sPLA2-IIA, myeloperoxidase, Lp-PLA2 and OxLDL were related to indices of stenosis severity in patients with stable coronary artery disease.
Methods: We studied 197 consecutive stable angina patients due to single vessel disease. Diagnostic coronary angiogram and fractional flow reserve (FFR) were performed. FFR ≤0.80 is indicative of functionally significant lesion and is a surrogate index of inducible myocardial ischemia. Morphologic lesion severity were assessed by quantitative coronary angiography [QCA]. At cardiac catheterization, blood was withdrawn and serum levels of biomarkers were assessed using commercially available assays.
Results: Clinical characteristics were similar between the group of patients with FFR > 0.8 and FFR ≤ 0.8. Lp-PLA2 and MPO were similar between both groups. sPLA2 activity, sPLA2 IIA and OxLDL was higher in FFR ≤ 0.8 vs FFR>0.8 group (table). At multivariate analysis using quartiles with adjustment for age, gender, previous PCI, smoking status and GFR, the highest quartiles of either sPLA2 activity, sPLA2-IIA or OxLDL levels were predictive of the FFR ≤ 0.8 (sPLA2 activity: odd ratio [OR]: 3.29; 95% confidence interval [CI]: 1.22–8.84; P = 0.018, sPLA2 IIA: odd ratio [OR]: 3.61; 95% confidence interval [CI]: 1.18–11.05; P = 0.024, OxLDL odd ratio [OR]: 6.06; 95% confidence interval [CI]: 2.17–16.94; P = 0.001). Note, no significant correlation between sPLA2 activity, sPLA2-IIA, OxLDL and QCA was noted.
Conclusion: Serum levels of sPLA2 activity, sPLA2-IIA and oxLDL are related to functional rather than morphologic characteristics of coronary stenoses. This suggests that biomarkers involved in generation of modified lipoproteins may be predictive of inducible ischemia in patients with stable coronary artery.
- © 2010 by American Heart Association, Inc.