Lipoprotein-associated Phospholipase A2, a Novel Cardiovascular Inflammatory Marker, in HIV-infected Patients

Overview

Journal Clin Infect Dis

Publisher Oxford University Press

Specialty Infectious Diseases

Date 2013 Dec 17

PMID 24336757

Citations 11

Authors

Alexandra Mangili

Raabia Ahmad

Robert L Wolfert

Jeffrey Kuvin

Joseph F Polak

Richard H Karas

Christine A Wanke

Affiliations

Soon will be listed here.

Abstract

Background: Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an emerging biomarker of cardiovascular disease. This study was conducted to describe the distribution of Lp-PLA2 in a cohort of human immunodeficiency virus (HIV)-infected adults and to determine associations between Lp-PLA2, cardiometabolic risk factors, and subclinical atherosclerosis in this population.

Methods: Lp-PLA2 was assessed in 341 (25% women, 52% white, 74% on highly active antiretroviral therapy [HAART]) participants of a cohort with detailed characterization of atherogenic risk factors, including surrogate markers of carotid and coronary atherosclerosis.

Results: Mean Lp-PLA2 mass was 313 ± 105 ng/mL and activity 173 ± 49 nmol/minute/mL. Seventy-five percent of participants had abnormal Lp-PLA2. Those in the highest Framingham Risk Score tertile had significantly higher Lp-PLA2 activity. Participants with abnormal carotid intima-media thickness (cIMT) had higher Lp-PLA2 mass and activity. Those with coronary artery calcium (CAC) scores >100 had significantly higher Lp-PLA2 mass than those with lower or nondetectable calcium. Those on HAART and protease inhibitor (PI)-based treatment had significantly higher Lp-PLA2 mass and activity than those who were treatment-naive or not on PIs. In multivariate regression, HAART and PI use were positively associated with Lp-PLA2 activity and mass after adjusting for age, race, sex, low-density and high-density lipoprotein cholesterol levels, triglyceride level, and smoking. Adding Lp-PLA2 activity tertiles to the model improved the predictive value for abnormal common cIMT, but not internal cIMT or CAC score.

Conclusions: Lp-PLA2 is highly abnormal in HIV-infected patients and is associated with several cardiovascular and HIV treatment-specific risk factors. Lp-PLA2 may be used as an additional and more vascular specific biomarker for cardiovascular risk stratification in HIV-positive patients.

Citing Articles

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References

Wilson P, DAgostino R, Levy D, Belanger A, Silbershatz H, Kannel W . Prediction of coronary heart disease using risk factor categories. Circulation. 1998; 97(18):1837-47. DOI: 10.1161/01.cir.97.18.1837. View

Corson M, Jones P, Davidson M . Review of the evidence for the clinical utility of lipoprotein-associated phospholipase A2 as a cardiovascular risk marker. Am J Cardiol. 2008; 101(12A):41F-50F. DOI: 10.1016/j.amjcard.2008.04.018. View

Agatston A, Janowitz W, HILDNER F, Zusmer N, VIAMONTE Jr M, Detrano R . Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol. 1990; 15(4):827-32. DOI: 10.1016/0735-1097(90)90282-t. View

Bozzette S, Ake C, Tam H, Chang S, Louis T . Cardiovascular and cerebrovascular events in patients treated for human immunodeficiency virus infection. N Engl J Med. 2003; 348(8):702-10. DOI: 10.1056/NEJMoa022048. View

Madjid M, Ali M, Willerson J . Lipoprotein-associated phospholipase A2 as a novel risk marker for cardiovascular disease: a systematic review of the literature. Tex Heart Inst J. 2010; 37(1):25-39. PMC: 2829807. View

Libby P . Inflammation and cardiovascular disease mechanisms. Am J Clin Nutr. 2006; 83(2):456S-460S. DOI: 10.1093/ajcn/83.2.456S. View

Pearson T, Mensah G, Alexander R, Anderson J, Cannon 3rd R, Criqui M . Markers of inflammation and cardiovascular disease: application to clinical and public health practice: A statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation. 2003; 107(3):499-511. DOI: 10.1161/01.cir.0000052939.59093.45. View

Stewart R, White H . The role of lipoprotein-associated phospholipase a₂ as a marker and potential therapeutic target in atherosclerosis. Curr Atheroscler Rep. 2011; 13(2):132-7. DOI: 10.1007/s11883-010-0158-8. View

Mangili A, Polak J, Quach L, Gerrior J, Wanke C . Markers of atherosclerosis and inflammation and mortality in patients with HIV infection. Atherosclerosis. 2010; 214(2):468-73. PMC: 3034311. DOI: 10.1016/j.atherosclerosis.2010.11.013. View

10.

Carr J, Danitschek J, Goff D, Crouse 3rd J, DAgostino R, Chen M . Coronary artery calcium quantification with retrospectively gated helical CT: protocols and techniques. Int J Cardiovasc Imaging. 2001; 17(3):213-20. DOI: 10.1023/a:1010604724001. View

11.

Mangili A, Gerrior J, Tang A, OLeary D, Polak J, Schaefer E . Risk of cardiovascular disease in a cohort of HIV-infected adults: a study using carotid intima-media thickness and coronary artery calcium score. Clin Infect Dis. 2006; 43(11):1482-9. DOI: 10.1086/509575. View

12.

Schambelan M, Wilson P, Yarasheski K, Cade W, Davila-Roman V, DAgostino Sr R . Development of appropriate coronary heart disease risk prediction models in HIV-infected patients. Circulation. 2008; 118(2):e48-53. PMC: 2648861. DOI: 10.1161/CIRCULATIONAHA.107.189627. View

13.

Greenland P, Smith Jr S, Grundy S . Improving coronary heart disease risk assessment in asymptomatic people: role of traditional risk factors and noninvasive cardiovascular tests. Circulation. 2001; 104(15):1863-7. DOI: 10.1161/hc4201.097189. View

14.

Acevedo M, Sprecher D, Calabrese L, Pearce G, Coyner D, Halliburton S . Pilot study of coronary atherosclerotic risk and plaque burden in HIV patients: 'a call for cardiovascular prevention'. Atherosclerosis. 2002; 163(2):349-54. DOI: 10.1016/s0021-9150(02)00016-3. View

15.

Stein J, Korcarz C, Hurst R, Lonn E, Kendall C, Mohler E . Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Endorsed by the Society for.... J Am Soc Echocardiogr. 2008; 21(2):93-111. DOI: 10.1016/j.echo.2007.11.011. View

16.

Mahoney L, Burns T, Stanford W, Thompson B, Witt J, Rost C . Coronary risk factors measured in childhood and young adult life are associated with coronary artery calcification in young adults: the Muscatine Study. J Am Coll Cardiol. 1996; 27(2):277-84. DOI: 10.1016/0735-1097(95)00461-0. View

17.

Davidson M, Corson M, Alberts M, Anderson J, Gorelick P, Jones P . Consensus panel recommendation for incorporating lipoprotein-associated phospholipase A2 testing into cardiovascular disease risk assessment guidelines. Am J Cardiol. 2008; 101(12A):51F-57F. DOI: 10.1016/j.amjcard.2008.04.019. View

18.

OLeary D, Polak J, Kronmal R, Savage P, Borhani N, Kittner S . Thickening of the carotid wall. A marker for atherosclerosis in the elderly? Cardiovascular Health Study Collaborative Research Group. Stroke. 1996; 27(2):224-31. DOI: 10.1161/01.str.27.2.224. View

19.

Sankatsing R, de Groot E, Jukema J, de Feyter P, Pennell D, Schoenhagen P . Surrogate markers for atherosclerotic disease. Curr Opin Lipidol. 2005; 16(4):434-41. DOI: 10.1097/01.mol.0000174400.68938.f6. View

20.

OLeary D, Polak J . Intima-media thickness: a tool for atherosclerosis imaging and event prediction. Am J Cardiol. 2002; 90(10C):18L-21L. DOI: 10.1016/s0002-9149(02)02957-0. View