Utility of Lp-PLA2
A number of recent studies have demonstrated a major role for inflammation in atherogenesis, the pathophysiology of vulnerable plaque and, consequently, of cardiovascular events. Circulating markers of inflammation (e.g., CRP as measured by an hs-method ) have attracted considerable interest as predictors of cardiovascular risk. High levels of lipoprotein-associated phospholipase A2 [Lp-PLA(2)] are present in inflamed, rupture-prone plaques, and it appears that Lp-PLA(2) is released from these plaques into circulation before the plaque ruptures.
In other words this marker, like hs-CRP, but unlike the troponins (as a marker of cardiac cell damage and death) is a risk marker. Research has shown that an elevated Lp-PLA(2) level nearly doubles the risk for cardiovascular events. When both CRP and Lp-PLA(2) are increased, they provide an even greater predictive capability to help identify very-high-risk individuals who would benefit from aggressive lipid-lowering therapy. This observation suggests the two markers are largely independent. Studies have shown a positive association with CHF, stroke and Lp-PLA(2). A consensus panel reviewed the literature on the Lp-PLA(2). Consistent with the ATP III guideline recommendations for the use of inflammatory markers, Lp-PLA(2) is recommended as an adjunct to traditional risk assessment in patients at moderate and a high 10-year risk. The panel suggest also that "elevated Lp-PLA(2) levels should prompt consideration of increasing the cardiovascular risk category from moderate to high or high to very high risk, respectively. At this time Lp-PLA(2) should be viewed as an important cardiovascular risk marker whose utility is as an adjunct to the major risk factors. However, currently Lp-PLA(2) cannot be recommended as a target for therapy."
Note: As of this writing, this assay is adaptable to a number of chemistry analyzers with others to follow. An extensive bibliography and/or abstracts are available from the author at davidplaut@yahoo.com.