-PLA2 testing is well-studied and published in peer-reviewed scientific literature and is recognized in the guidelines of the American Heart Association and the American Stroke Association7,8
About 10% to 20% of persons with coronary heart disease (CHD) have no identifiable risk factor,1 and 35% of CHD deaths occur in patients who have total serum cholesterol levels of less than 200 mg/dL.2
Measurement of inflammatory markers such as hs-CRP or Lp-PLA2 in patients without CVD may be considered to identify patients who may be at increased risk of stroke, although their effectiveness (ie, usefulness in routine clinical practice) is not well established
Lipoprotein-associated phospholipase A2 might be reasonable for cardiovascular risk assessment in intermediate-risk asymptomatic adults. (Level of Evidence: B) http://www.cardiosource.org/~/media/Files/Science%20and%20Quality/Guidelines/Pocket%20Guides/CV%20Risk%20Pocket%20Guide.ashx
In conclusion, in patients with CHD treated with atorvastatin, plasma levels of Lp(a), neopterin, NT-proBNP, and sRAGE are associated with the risk of recurrent MCVEs.
Although Lp-PLA2 is independently associated with silent brain infarcts in women, its addition to clinical variables does not lead to any improvement in their prediction.http://www.ncbi.nlm.nih.gov/pubmed/25463126
Multimarker approach in discriminating patients with symptomatic and asymptomatic atherosclerotic carotid artery stenosis.an increase in circulating osteoprotegerin and Lp-PLA2 may transiently indicate S transformation of the carotid atherosclerotic plaque.
lipoprotein-associated phospholipase A2 mass to risk scores containing total cholesterol and HDL-C led to slight improvement in CVD prediction.
In a study of individuals without known CVD, the addition of information on the combination of apolipoprotein B and A-I, lipoprotein(a), or lipoprotein-associated phospholipase A2 mass to risk scores containing total cholesterol and HDL-C led to slight improvement in CVD prediction Net reclassification improvements were less than 1% with the addition of each of these markers to risk scores containing conventional risk factors. and lipoprotein-associated phospholipase A2 mass, 2.7% of people to a 20% or higher predicted CVD risk category and, therefore, in need of statin treatment under Adult Treatment Panel III guidelines.
Comparison of individuals in the top third of baseline plasma Lp(a) measurements with those in the bottom third in each study yielded a combined risk ratio of 1.6 (95% CI 1.4 to 1.8, 2P<0.00001), with similar findings when the analyses were restricted to the 18 studies of general populations (combined risk ratio 1.7, 95% CI 1.4 to 1.9; 2P<0.00001)
We estimated that for 100,000 adults aged 40 years or older, 15,436 would be initially classified at intermediate risk using conventional risk factors alone. Additional testing with a combination of apolipoprotein B and A-I would reclassify 1.1%; lipoprotein(a), 4.1%; and lipoprotein-associated phospholipase A2 mass, 2.7% of people to a 20% or higher predicted CVD risk category and, therefore, in need of statin treatment under Adult Treatment Panel III guidelines.
http://www.ncbi.nlm.nih.gov/pubmed/22797450http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4211641/ http://www.ncbi.nlm.nih.gov/pubmed/20005516 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846186/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2829807/
“Lipoproteins do not add meaningfully to risk estimation before treatment or prediction of benefit with treatment”