Lipoprotein-associated phospholipase-A(2) activity and its diagnostic potential in patients with acute coronary syndrome and acute ischemic stroke

Abstract

Background: The study examined the Lp-PLA(2) activity at the patients presented to the emergency department with acute coronary syndrome (ACS) or acute ischemic stroke (AIS), as well as its diagnostic value. Methods: The prospective study included consecutive male and female patients aged >18 years that presented to the our emergency department with ACS or AIS between November 2009 and January 2010. Blood samples were obtained immediately following diagnosis in the ACS and AIS groups. The diagnostic value of Lp-PLA(2) was determined based on receiver operating characteristic curves, sensitivity, specificity, predictive values, likelihood ratios and accuracy rates. Results: In all, 34 ACS and 32 AIS patients were included in the study, and the control group included 35 patients. Lp-PLA(2) enzyme activity was significantly lower in the ACS and AIS groups than in the control group (26.7 +/- 13.8, 31.4 +/- 13.6, and 41.4 +/- 8.1 nmol min(-1).mL(-1), respectively; p < 0.0001, p = 0.022). In the ACS group the area under the curve (AUC) was 0.825 (95% CI: 0.722-0.929), sensitivity was 71% for an optimal Lp-PLA(2) cut-off value of 31.4 nmol min(-1).mL(-1), and specificity was 91%, whereas in the AIS group the AUC was 0.768 (95% CI: 0.652-0.884), sensitivity was 75% for an optimal Lp-PLA(2) cut-off value of 38.1 nmol min(-1).mL(-1), and specificity was 74%. Conclusions: Lp-PLA(2) enzyme activity was significantly lower during the early stage of both ACS and AIS. The obtained statistic data suggest that low Lp-PLA(2) enzyme activity can be used for diagnostic purposes. Copyright (C) 2016 The Emergency Medicine Association of Turkey. Production and hosting by Elsevier B.V. on behalf of the Owner. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).