[Lipoprotein-associated phospholipase A2: relation to development of ischemic stroke in patients with essential...

to investigate association of lipoprotein-associated phospholipase A2 (Lp-PLA2) level (mass) with ischemic stroke in patients with essential hypertension (EH) with or without dyslipidemia.

We examined 60 patients with EH without complications and 90patients with EH and history of ischemic stroke. Examination included measurement of height, weight, waist, blood pressure and heart rate, determination of glucose, creatinine, lipid profile, Lp-PLA2 mass, and duplex scanning of carotid arteries. All patients were divided into 2groups: A) with high (n=70), and B) normal or mildly elevated (n=80) levels of low density lipoprotein cholesterol (LDLC).

In group A (LDLC <3.4 mmol/L) Lp-PLA2 mass in patients with stroke was higher than in patients with uncomplicated EH; age and elevated Lp-PLA2 mass were independently associated with history of stroke. In group B (LDLC >3.4 mmol/L) Lp-PLA2 mass did not differ between patients with EH with or without stroke while low level of high density lipoprotein cholesterol was most significantly associated with history of stroke.

These results suggest that the role of LP-PLA2 in the development of ischemic stroke is reduced in the presence of evident dyslipidemia and high level of traditional cardiovascular risk factors. However, in the presence of low level of traditional metabolic risk factors proinflammatory substances and LP-PLA2 in particular acquire dominant role in the processes of atherogenesis and plaque destabilization.