High-Sensitivity C-Reactive Protein and Lipoprotein-Associated Phospholipase A 2 Stability Before and After Stroke and Myocardial Infarction
Open accessAbstract
Background and Purpose— High-sensitivity C-reactive protein (hsCRP) and lipoprotein-associated phospholipase A 2 (Lp-PLA 2 ) are hypothesized to be biomarkers of systemic inflammation and risk of myocardial infarction (MI) and stroke. Little is known, however, about the stability of these markers over time, and in particular, about the effects of acute vascular events on these marker levels. Methods— Serum samples were collected at 4 annual intervals in 52 stroke-free participants from the Northern Manhattan Study (NOMAS) and assayed for hsCRP and Lp-PLA 2 mass and activity levels using standard techniques. Log transformation of levels was performed as needed to stabilize the variance. Stability of marker levels over time was assessed using random effects models unadjusted and adjusted for demographics and other risk factors. In addition, samples from 37 initially stroke-free participants with stroke (n=17) or MI (n=20) were available for measurement before and after the vascular event (median 5 days, range 2 to 40 days). Levels before and after events were compared using nonparametric tests. Results— HsCRP and Lp-PLA 2 activity levels were stable over time, whereas Lp-PLA 2 mass levels decreased on average 5% per year ( P =0.0015). Using accepted thresholds to define risk categories of Lp-PLA 2 mass, there was no significant change over time. HsCRP increased after stroke (from median 2.2 mg/L prestroke to 6.5 mg/L poststroke; P =0.0067) and MI (from median 2.5 mg/L pre-MI to 13.5 mg/L post-MI; P <0.0001). Lp-PLA 2 mass and activity levels both decreased significantly after stroke and MI (for Lp-PLA 2 mass, from median 210.0 ng/mL to 169.4 ng/mL poststroke, P =0.0348, and from median 233.0 ng/mL to 153.9 post-MI, P <0.0001). Conclusion— Lp-PLA 2 mass levels decrease modestly, whereas hsCRP and Lp-PLA 2 activity appear stable over time. Acutely after stroke and MI, hsCRP increases whereas Lp-PLA 2 mass and activity levels decrease. These changes imply that measurements made soon after stroke and MI are not reflective of prestroke levels and may be less reliable for long-term risk stratification.
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No change in Lp-PLA2 over time was observed in placebo arms of trials of Lp-PLA2 inhibitors or in studies of Lp-PLA2 stability.
“Furthermore, no change in Lp-PLA2 over time was observed in the placebo arms of trials evaluating potential inhibitors of this pathway 18,19 or in studies of stability of circulating Lp-PLA2 levels over time.20”
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Atherosclerosis--an inflammatory disease
Ross, R. (1999) · New England Journal of Medicine · doi:10.1056/nejm199901143400207 · Cited by 21,725 · see citing works
Pearson, T. A., Mensah, G. A., Alexander, R. W., Anderson, J. L., Cannon, R. O., Criqui, M., Fadl, Y. Y., Fortmann, S. P., Hong, Y., Myers, G. L., et al. (2003) · Circulation · doi:10.1161/01.cir.0000052939.59093.45 · Cited by 6,401 · see citing works
PearsonT, A., MensahG, A., & AlexanderR, W. (2003) · Journal of Cardiopulmonary Rehabilitation · doi:10.1097/00008483-200305000-00016 · Cited by 2,937 · see citing works
Inflammation in Atherosclerosis: From Vascular Biology to Biomarker Discovery and Risk Prediction
Packard, R. R. S., & Libby, P. (2008) · Clinical Chemistry · doi:10.1373/clinchem.2007.097360 · Cited by 925 · see citing works
Lipoprotein-Associated Phospholipase A 2 as an Independent Predictor of Coronary Heart Disease
Packard, C. J., O’Reilly, D. S. J., CASLAKE, M. J., McMahon, A. D., Ford, I., Cooney, J., Macphee, C. H., Suckling, K. E., Krishna, M., Wilkinson, F. E., et al. (2000) · New England Journal of Medicine · doi:10.1056/nejm200010193431603 · Cited by 822 · see citing works
Oei, H.-H. S., van der Meer, I. M., Albert Hofman, D., Koudstaal, P. J., Stijnen, T., Breteler, M. M. B., & Witteman, J. C. M. (2005) · Circulation · doi:10.1161/01.cir.0000154553.12214.cd · Cited by 423 · see citing works
The Behavioral Risk Factor Surveys: II. Design, Methods, and Estimates from Combined State Data
Gentry, E. M., Kalsbeek, W. D., Hogelin, G. C., Jones, J. T., Gaines, K. L., Forman, M. R., Marks, J. S., & Trowbridge, F. L. (1985) · American Journal of Preventive Medicine · doi:10.1016/s0749-3797(18)31372-2 · Cited by 338 · see citing works
Evaluation of C-Reactive Protein Measurement for Assessing the Risk and Prognosis in Ischemic Stroke
Napoli, M. D., Schwaninger, M., Cappelli, R., Ceccarelli, E., Gianfilippo, G. D., Donati, C., Emsley, H. C. A., Forconi, S., Hopkins, S. J., Masotti, L., et al. (2005) · Stroke · doi:10.1161/01.str.0000165929.78756.ed · Cited by 288 · see citing works
CASLAKE, M. J., Packard, C. J., Suckling, K. E., Holmes, S. D., Chamberlain, P., & Macphee, C. H. (2000) · Atherosclerosis · doi:10.1016/s0021-9150(99)00406-2 · Cited by 262 · see citing works
Elkind, M. S. V., Tai, W., Coates, K., Paik, M. C., & Sacco, R. L. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.19.2073 · Cited by 255 · see citing works
Self-citationO’Donoghue, M. L., Morrow, D. A., Sabatine, M. S., Murphy, S. A., McCabe, C. H., Cannon, C. P., & D, E. B. M. (2006) · Circulation · doi:10.1161/circulationaha.105.612630 · Cited by 228 · see citing works
Homocysteine and the Risk of Ischemic Stroke in a Triethnic Cohort
Sacco, R. L., Anand, K., Lee, H. S., Boden-Albala, B. M., Stabler, S. P., Allen, R. H., & Paik, M. C. (2004) · Stroke · doi:10.1161/01.str.0000142374.33919.92 · Cited by 210 · see citing works
Self-citationCorson, M. A., Jones, P. H., & Davidson, M. H. (2008) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2008.04.018 · Cited by 123 · see citing works
Inflammation, Atherosclerosis, and Stroke
Elkind, M. S. V. (2006) · The Neurologist · doi:10.1097/01.nrl.0000215789.70804.b0 · Cited by 120 · see citing works
Self-citationIribarren, C., Gross, M. D., Darbinian, J. A., Jacobs, D. R., Sidney, S. S., & Loria, C. M. (2004) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/01.atv.0000148322.89911.44 · Cited by 108 · see citing works
The effect of statin therapy on lipoprotein associated phospholipase A2 levels
Albert, M. A., Glynn, R. J., Wolfert, R. L., et al. (2005) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2005.05.006 · Cited by 91 · see citing works
Fluctuating Inflammatory Markers in Patients With Stable Ischemic Heart Disease
Bogaty, P. M. (2005) · Archives of Internal Medicine · doi:10.1001/archinte.165.2.221 · Cited by 89 · see citing works
Kargman, D. E., Tuck, C. H., Berglund, L., Lin, I., Mukherjee, R. S., Thompson, E. V., Jones, J. L., Boden-Albala, B. M., Paik, M. C., & Sacco, R. L. (1998) · Atherosclerosis · doi:10.1016/s0021-9150(98)00085-9 · Cited by 82 · see citing works
Self-citationLipoprotein-Associated Phospholipase A2 Activity and Risk of Recurrent Stroke
Elkind, M. S. V., Tai, W., Coates, K., Paik, M. C., & Sacco, R. L. (2008) · Cerebrovascular Diseases · doi:10.1159/000172633 · Cited by 72 · see citing works
Self-citationAlley, D. E., Crimmins, E. M., Bandeen‐Roche, K., Guralnik, J. M., & Ferrucci, L. (2007) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2007.01390.x · Cited by 61 · see citing works
Lanman, R. B., Wolfert, R. L., Fleming, J. K., Jaffe, A. S., Roberts, W. L., Warnick, G. R., & McConnell, J. P. (2006) · Preventive Cardiology · doi:10.1111/j.1520-037x.2006.05547.x · Cited by 45 · see citing works
Levels of acute phase proteins remain stable after ischemic stroke
Elkind, M. S. V., Coates, K., Tai, W., Paik, M. C., Boden-Albala, B. M., & Sacco, R. L. (2006) · BMC Neurology · doi:10.1186/1471-2377-6-37 · Cited by 41 · see citing works
Self-citationKayaba, K., Ishikawa, S., Gotoh, T., Nago, N., Kajii, E., Nakamura, Y., & Kario, K. (2000) · Japanese Circulation Journal-english Edition · doi:10.1253/jcj.64.303 · Cited by 39 · see citing works
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Avan, A., Tavakoly Sany, S. B., Ghayour‐Mobarhan, M., Rahimi, H. R., Tajfard, M., & Ferns, G. (2018) · Journal of Cellular Physiology · doi:10.1002/jcp.26791 · Cited by 182 · see citing works
Ridker, P. M., Rifai, N., MacFadyen, J., Glynn, R. J., Jiao, L., Steg, P. G., Miller, M., Brinton, E. A., Jacobson, T. A., Tardif, J.-C., et al. (2022) · Circulation · doi:10.1161/circulationaha.122.059410 · Cited by 131 · see citing works
- Authors
- Elkind, M. S. V., Leon, V., Moon, Y. P., Paik, M. C., & Sacco, R. L.
- Affiliations
- University of Miami (US)
- Venue
- Stroke
- Published
- 2009-10
- Volume
- 40
- Issue
- 10
- Pages
- 3233-3237
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- PMC
- PMC2761676
- OpenAlex
- W2081598122
- Cited by
- 52
- References
- 23
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 1 · 2022: 4 · 2021: 2 · 2019: 2 · 2018: 5 · 2017: 3 · 2016: 5 · 2015: 2 · 2014: 5 · 2013: 5 · 2012: 3
- FWCI
- 5.39
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Neurological Disorders and Stroke (K23NS042912, R01NS048134, R37NS029993, R01NS48134, R37 NS 29993.)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Keywords
- high-sensitivity C-reactive protein, lipoprotein-associated phospholipase A2, Lp-PLA2 activity, biomarker stability, myocardial infarction, systemic inflammation, acute vascular events, Northern Manhattan Study, cardiovascular risk markers
- MeSH terms
- Aged, Aged, 80 and over, C-Reactive Protein, Female, Humans, Male, Middle Aged, Myocardial Infarction, Predictive Value of Tests, Risk Factors, Time Factors, Biomarkers, Down-Regulation, Stroke, 1-Alkyl-2-acetylglycerophosphocholine Esterase
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