Link between Lipoprotein-Associated Phospholipase A2 Gene Expression of Peripheral-Blood Mononuclear Cells and Prognostic Outcome after Acute Ischemic Stroke

Tzu-Hsien Tsai; Yung-Lung Chen; Hung-Sheng Lin; Chu-Feng Liu; Hsuen-Wen Chang; Cheng-Hsien Lu; Wen-Neng Chang; Shu-Feng Chen; Chiung-Jen Wu; Steve Leu; Sheung-Fat Ko; Hon-Kan Yip

doi:10.5551/jat.10751

Original Article

Link between Lipoprotein-Associated Phospholipase A₂ Gene Expression of Peripheral-Blood Mononuclear Cells and Prognostic Outcome after Acute Ischemic Stroke

Tzu-Hsien Tsai, Yung-Lung Chen, Hung-Sheng Lin, Chu-Feng Liu, Hsuen-Wen Chang, Cheng-Hsien Lu, Wen-Neng Chang, Shu-Feng Chen, Chiung-Jen Wu, Steve Leu, Sheung-Fat Ko, Hon-Kan Yip

Author information

Tzu-Hsien Tsai
Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine.
Yung-Lung Chen
Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine.
Hung-Sheng Lin
Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine.
Chu-Feng Liu
Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine.
Hsuen-Wen Chang
Department of Biological Sciences, National Sun Yat-Sen University.
Cheng-Hsien Lu
Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine.
Wen-Neng Chang
Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine.
Shu-Feng Chen
Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine.
Chiung-Jen Wu
Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine.
Steve Leu
Center for Translational Research in Biomedical Science, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine.
Sheung-Fat Ko
Department of Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine.
Hon-Kan Yip
Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine.

Keywords: Acute ischemic stroke, Lipoprotein-associated phospholipase A₂ activity, Clinical outcome

JOURNAL OPEN ACCESS

2012 Volume 19 Issue 6 Pages 523-531

DOI https://doi.org/10.5551/jat.10751

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Details

Abstract

Aim: To evaluate the potential of the lipoprotein-associated phospholipase A₂ (Lp-PLA₂) level as a biomarker in the prediction of prognostic outcome in patients with acute ischemic stroke (IS).
Methods: From October 2008 to March 2010, 130 patients with acute IS were prospectively enrolled in the study and their medical records were reviewed. A blood sample was collected from each patient 48 hours after acute IS, as well as from 20 healthy volunteers as controls. Messenger-RNA (mRNA) expression of Lp-PLA₂ of peripheral-blood mononuclear cells (PBMNCs) relative to that of β actin was measured using quantitative reverse transcription polymerase chain reaction (RT-PCR).
Results: Patients with acute IS exhibited significantly higher Lp-PLA₂ mRNA expression of PBMNCs than the control group (p <0.0001). Lp-PLA₂ mRNA expression of PBMNCs in patients with a major adverse clinical outcome (MACO) (defined as recurrent stroke or death) within 90 days was significantly higher than in patients without MACO (p=0.006). Furthermore, elevated Lp-PLA₂ mRNA expression was strongly associated with old age, diabetes mellitus, a positive history of significant coronary arterial disease and significant stenosis of the extra-cranial carotid arteries (all p <0.04), and positively correlated with the body mass index, leukocyte count, and serum levels of total cholesterol and low-density lipoprotein cholesterol. Multivariate analysis revealed that Lp-PLA₂ mRNA expression of PBMNCs was a significant independent predictor of MACO within 90 days (p= 0.011).
Conclusion: Elevated Lp-PLA₂ mRNA expression of PBMNCs seems to be a potential biomarker for predicting an unfavorable outcome in patients with acute IS.

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