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

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 sPLA₂ and CRP levels did not change after coronary angiography. The level of sPLA₂ significantly increased immediately after PCI. Creatine kinase and cardiac injury markers did not rise immediately after PCI, but elevated significantly at 24 h after intervention. After a 2-year follow up, increased sPLA ₂ (>450 ng/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 sPLA₂ following the mechanical disruption of coronary plaque, and the elevated level of sPLA₂ had significant prognostic impact.