Author + information
- Received March 30, 2005
- Revision received May 25, 2005
- Accepted June 6, 2005
- Published online October 4, 2005.
- Ziad Mallat, MD, PhD⁎,⁎ (, )
- Ph. Gabriel Steg, MD, PhD†,
- Joëlle Benessiano, MD, PhD‡,
- Marie-Laure Tanguy, PhD§,
- Keith A. Fox, FESC∥,
- Jean-Philippe Collet, MD, PhD¶,
- Omar H. Dabbous, MD, MPH#,
- Patrick Henry, MD⁎⁎,
- Kathryn F. Carruthers, MPhil∥,
- Anne Dauphin, MSc‡,
- Carla Sibella Arguelles, MSc‡,
- Joëlle Masliah, PhD††,
- Bénédicte Hugel, PhD‡‡,
- Gilles Montalescot, MD, PhD¶,
- Jean-Marie Freyssinet, PhD‡‡,
- Bernard Asselain, PhD§ and
- Alain Tedgui, PhD⁎
- ↵⁎Reprint requests and correspondence:
Dr. Ziad Mallat, Inserm U541, Hôpital Lariboisière, 75010 Paris, France.
Objectives The purpose of this study was to determine the prognostic value of circulating secretory phospholipase A2 (sPLA2) activity in patients with acute coronary syndromes (ACS).
Background The plasma level of type IIA sPLA2 is a risk factor for coronary artery disease (CAD) and is associated with adverse outcomes in patients with stable CAD. The prognostic impact of sPLA2 in patients with ACS is unknown.
Methods Secretory phospholipase A2 antigen levels and activity were measured in plasma samples of 446 patients with ACS, obtained at the time of enrollment.
Results Baseline sPLA2 activity was associated with the risk of death and myocardial infarction (MI). The unadjusted rate of death and MI increased in a stepwise fashion with increasing tertiles of sPLA2 activity (p < 0.0001). The association remained significant in the subgroup of patients who had MI with ST-segment elevation (p = 0.014) and the subgroup of patients who had unstable angina or non–ST-segment elevation MI (p < 0.002). After adjustment for clinical and biological variables, the hazard ratios for the combined end point of death or MI in the third tertile of sPLA2 compared with the first and second tertiles was 3.08 (95% confidence interval, 1.37 to 6.91, p = 0.006).
Conclusions A single measurement of plasma sPLA2 activity at the time of enrollment provides strong independent information to predict recurrent events in patients with ACS.
This study was supported by a grant from Fondation pour la Recherche Médicale, Action Santé 2000, RBM 99057 from INSERM, and an unrestricted grant from Aventis. Drs. Mallat and Steg contributed equally to this work.
- Received March 30, 2005.
- Revision received May 25, 2005.
- Accepted June 6, 2005.
- American College of Cardiology Foundation