Circulating levels of secretory type II phospholipase A(2) predict coronary events in patients with coronary artery disease

Background-The circulating levels of secretory nonpancreatic type II phosph olipase A(2) (sPLA(2)) an increased in various chronic inflammatory disease s and the increase in the levels correlates with the disease severity. sPLA (2) may possibly play a role in atherogenesis and is highly expressed in at herosclerotic arterial walls that are known to have inflammatory features. Thus, this study prospectively examined whether circulating levels of sPLA( 2) may have a significant risk and prognostic values in patients with coron ary artery disease (CAD). Methods and Results-Plasma levels of sPLA(2) were measured in 142 patients with CAD and in 93 control subjects by a radioimmunoassay. The sPLA(2) leve ls had a significant and positive relations with serum levels of C-reactive protein, a marker of systemic inflammation, and with the number of the tra ditional coronary risk factors associated with individuals. Multivariate lo gistic regression analysis showed that higher levels of sPLA(2) (>246 ng/dL ; 75th percentile of sPLA(2) distribution in controls) were a significant a nd independent risk factor for the presence of CAD. In multivariate Cox haz ard analysis, the higher levels of sPLA2 were a significant predictor of de veloping coronary events (ie, coronary revascularization, myocardial infarc tion, coronary death) during a 2-year follow-up period in patients with CAD independent of other risk factors, including CRP levels, an established in flammatory predictor. Conclusions-The increase in circulating levels of sPLA(2) is a significant risk factor for the presence of CAD and predicts clinical coronary events i ndependent of other risk factors in patients with CAD; these results may re flect possible relation of sPLA(2) levels with inflammatory activity in ath erosclerotic arteries.