Lipoprotein-associated phospholipase A2 and its relationship with markers of subclinical cardiovascular disease: A systematic review.

BACKGROUND: Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an enzyme that exhibits proinflammatory properties and has been associated with subclinical cardiovascular disease.

OBJECTIVE: The relationship between Lp-PLA2 and subclinical CVD remains unclear. The goal of this systematic review was to clarify this relationship.

METHODS: An extensive literature search of the MEDLINE database using Ovid and PubMed was performed. From an initial search of 444 articles, 13 met the inclusion and exclusion criteria and were included in the review.

RESULTS: Of the 13 studies included in the review, 6 examined the relationship between Lp-PLA2 and coronary artery calcification, of which 3 showed a significant correlation. Two studies examined the relationship between Lp-PLA2 and endothelial dysfunction, and 1 reported a significant relationship. Five studies investigated the association of Lp-PLA2 with carotid intima-media thickness (CIMT), and 3 reported a significant relationship.

CONCLUSIONS: This review shows a variable association between Lp-PLA2 and subclinical disease. This finding has broad implications for the future of public health and clinical practice. Future research is needed to clarify what role Lp-PLA2 has in guiding treatment and if it is involved in plaque instability, which would make it a useful tool for risk prognostication.