Prognostic value and the changes of plasma levels of secretory type II phospholipase A2 in patients with coronary artery disease undergoing percutaneous coronary intervention

Abstract

Aim To evaluate the serial changes of plasma secretory type II phospholipase A₂(sPLA₂), C-reactive protein (CRP) and cardiac injury markers in coronary artery disease (CAD) patients undergoing percutaneous coronary intervention (PCI) and their prognostic impacts. Methods and results Plasma levels of sPLA₂, CRP, creatine kinase (CK), CK-MB and troponin-T were measured in 247 consecutive CAD patients receiving PCI procedure and 100 control subjects without CAD. In CAD group, serial blood samples were taken before coronary angiography, after coronary angiography, immediately after PCI, 24-h and 48-h after PCI. The sPLA₂and CRP levels did not change after coronary angiography. The level of sPLA₂significantly increased immediately after PCI. Creatine kinase and cardiac injury markers did not rise immediately after PCI, but elevated significantly at 24h after intervention. After a 2-year follow up, increased sPLA₂(>450ng/dl) after PCI, smoking and diabetes mellitus were the independent risk factors for subsequent coronary events (odds ratios 2.1, 2.3 and 3.1, respectively) in patients with CAD. Conclusion The present study showed that PCI might cause immediate elevation of circulating levels of sPLA₂following the mechanical disruption of coronary plaque, and the elevated level of sPLA₂had significant prognostic impact.