Lp-PLA₂- a novel risk factor for high-risk coronary and carotid artery disease

Lipoprotein-associated phospholipase A2 (Lp-PLA₂) is at the crossroads of lipid metabolism and the inflammatory response. It is produced by inflammatory cells, bound to LDL and other lipoproteins, and once in the arterial wall facilitates hydrolysis of phospholipids. Elevated serum levels of Lp-PLA₂ have been associated with increased cardiovascular risk in healthy populations and in patients with known vascular disease. Here, we review the role of Lp-PLA₂ in the development of atherosclerosis and progression to unstable disease, the utility of Lp-PLA₂ as a risk predictor for coronary and carotid events and the potential clinical benefit of pharmacologic inhibition of Lp-PLA₂.