Abstract 16757: Admission Lipoprotein-Associated Phospholipase A2 Activity does not Predict Long-Term Mortality in ST-Segment Elevation Myocardial Infarction

Abstract

Background and Aim: Conflicting data has been published on the prognostic value of Lipoprotein-associated Phospholipase A2 (Lp-PLA2). The present study investigates the prognostic value of acute phase Lp-PLA2 activity levels in ST-segment Elevation Myocardial Infarction (STEMI) up to 5 years of follow-up.

Methods: Lp-PLA2 activity levels were measured in samples obtained prior to primary percutaneous coronary intervention (pPCI) from consecutive STEMI patients in a high-volume intervention centre. The patients are divided in tertiles; low, intermediate, and high (<144, 144-179, >179 mg/L/min) based on Lp-PLA2 activity levels. Long term mortality until the end of follow-up, and with a landmark at 30 days are estimated with the Kaplan-Meier method and compared with a log-rank test.

Results:In 978 STEMI patients acute phase Lp-PLA2 activity levels were measured. Among the Lp-PLA2 tertiles there are several significant differences in baseline characteristics. Long-term mortality until the end of follow-up was obtained with a median of 942 days. Overall mortality is 14.1% in the low group, and 16.1% in the intermediate group (p=0.79). In the high level group the mortality is 10.9%, which does not significantly differ from the low group (p=0.20). In addition, a landmark analysis at 30 days shows no significant differences between the groups (figure).

Conclusions: The acute phase levels of Lp-PLA2 activity in STEMI patients are not associated with short and/or long-term mortality. Lp-PLA2 and its role as an independent and clinically useful biomarker in the risk stratification of STEMI patients still remains to be proven.