PM212 Change in plasma phospholipase A2 mass and activity in subjects undergoing elective coronary stenting

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Introduction

Plasma phospholipase A2 (PLA2) enzymes are associated with cardiovascular (CV) risk and are involved with plaque progression. PLA2 enzymes are involved in atherosclerosis pathogenesis and endothelial dysfunction and may correlate with outcomes following percutaneous coronary intervention (PCI).

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Objectives

To define baseline and post PCI PLA2 levels in relation to clinical, angiographic and biochemial factors.

Methods

We prospectively collected arterial (n=79) and aortic/coronary sinus plasma (n=20 (results for 11)) for lp-PLA2 mass and activity assay and sPLA2 activity in subjects undergoing elective PCI. Patient, procedural, and angiographic characteristics and post procedural troponin were assessed.

Results

At baseline lp-PLA2 mass trended lower in more obese subjects (F 2.41, p=0.08) who were more likely to be on a statin. Greater lp-PLA2 mass increase post-PCI was seen in diabetics (173+/-338 vs 391+/-313, p=0.039). Subjects on chronic dual antiplatelet therapy (DAPT) had a trend to lower lp-PLA2 release (306.7 vs 146.3, p=0.11). s-PLA2 activity at baseline and change in trans-coronary lp-PLA2 activity with PCI correlated with troponin rise post PCI (r = 0.48 and r =0.61).

Conclusion

Lp-PLA2 mass and s-PLA2/lp-PLA2 activity correlate with baseline procedural characteristics and may predict those at greater risk of post PCI myocardial ischemia. Diabetics and older subjects demonstrate greater PLA2 release and DAPT may lower lp-PLA2 release during PCI.

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