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Association between serum lipoprotein-associated phospholipase A2, ischemic modified albumin and acute coronary syndrome: a cross-sectional study

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Abstract

Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a newly emerging biomarker with strong pro-inflammatory effects, and is an independent risk predictor of atherosclerotic plaque rupture and thrombosis. In addition, ischemic modified albumin (IMA) is another important marker for the evaluation of myocardial ischemia, and has been approved by the U.S. Food and Drug Administration. The objective of this study was to investigate serum Lp-PLA2 and IMA in the early diagnosis, progression and prognosis of acute coronary syndrome (ACS). Serum Lp-PLA2 and IMA were detected using an AU5800 automatic biochemical analyzer in samples from 180 patients with ACS [n = 60 with unstable angina pectoris (UA), n = 56 with non-ST segment elevation myocardial infarction (NSTEMI), and n = 64 with ST segment elevation myocardial infarction (STEMI)] and 60 healthy control subjects. The relationship between Lp-PLA2 and IMA with Gensini score and the number of coronary artery lesions was explored, and logistic regression was conducted to identify risk factors for major adverse cardiovascular events (MACE). Serum Lp-PLA2 and IMA were significantly higher in all ACS subgroups compared to the control group (P < 0.05), were positively associated with the severity of ACS based on the Gensini score (P < 0.05), and were significantly higher in patients with double- and triple-vessel lesions compared to those with single-vessel lesions and healthy controls (P < 0.05). Logistic regression identified Lp-PLA2, IMA, and troponin I levels as independent risk factors for MACE. Lp-PLA2 and IMA were predictive of the degree of myocardial ischemia in patients with ACS, and may provide important clinical significance for the early diagnosis of ACS and the choice of treatment strategy.

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Abbreviations

ACS:

Acute coronary syndrome

CI:

Confidence interval

HDL-C:

High-density lipoprotein cholesterol

IMA:

Ischemic modified albumin

LDL-C:

Low-density lipoprotein cholesterol

Lp-PLA2:

Lipoprotein-associated phospholipase A2

MACE:

Major adverse cardiovascular events

NSTEMI:

Non-ST segment elevation myocardial infarction

OR:

Odds ratio

PCI:

Percutaneous coronary intervention

STEMI:

ST segment elevation myocardial infarction

TC:

Total cholesterol

TG:

Triglycerides

TnI:

Troponin I

UA:

Unstable angina pectoris

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Funding

Research projects of Bengbu Medical College (BYKY17184, 18178), Young and Middle-aged Talents Growth Foundation of the Second People’s Hospital of Lianyungang (TQ201709), and Health Scientific Research Project in Lianyungang (201721, 201817).

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Author notes

  1. Fumeng Yang and Liping Ma are equal contributors.

Authors and Affiliations

  1. Department of Laboratory Medicine, The Second People’s Hospital of Lianyungang, 41 East Hailian Road, Lianyungang, 222006, Jiangsu, People’s Republic of China

    Fumeng Yang, Liping Ma, Changxin Zhao, Wenjun Zhu, Wei Liang & Qian Liu

  2. Department of Emergency, The Second People’s Hospital of Lianyungang, Lianyungang, People’s Republic of China

    Lili Zhang

  3. Department of Cardiovascular, The Second People’s Hospital of Lianyungang, Lianyungang, People’s Republic of China

    Yilian Wang

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  1. Fumeng Yang
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  4. Yilian Wang
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Contributions

FY and QL conceived and designed the experiments. LZ, YW, and CZ performed the experiments. WZ, WL and LM analyzed the data. FY, LM, and QL wrote or revised the manuscript. All the authors approved the final submitted version of the manuscript.

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Correspondence to Qian Liu.

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Yang, F., Ma, L., Zhang, L. et al. Association between serum lipoprotein-associated phospholipase A2, ischemic modified albumin and acute coronary syndrome: a cross-sectional study. Heart Vessels 34, 1608–1614 (2019). https://doi.org/10.1007/s00380-019-01403-3

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  • DOI: https://doi.org/10.1007/s00380-019-01403-3

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