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The diagnostic value of lipoprotein-related phospholipase A2 and matrix metalloproteinase-9 in identifying patients with coronary plaque or stenosis

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06 août 2025
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Background

Coronary computed tomography angiography (CCTA) is the gold standard method for detecting the presence of coronary plaque and stenosis in atherosclerosis. However, the nephrotoxic effects of contrast agents applied during angiography and the adverse effects of radiation are known. Alternative diagnostic tools are always needed to evaluate coronary arteries. Therefore, combining the results of CCTA with Lipoprotein-associated phospholipase A2 (Lp-PLA2) and Matrix metalloproteinase (MMP)-9, which are thought to be associated with atherosclerotic plaque, may reduce cardiovascular events in patients with suspected atherosclerosis.

Methods

In the serum samples collected from the control group and patients, CRP, triglyceride, total cholesterol, LDL-C, HDL-C, Lp-PLA2, and MMP-9 levels were analyzed. Receiver Operating Characteristic (ROC) analysis was applied to determine optimal cut-off values in identifying patients with coronary plaque or stenosis. The significance level was accepted as p<0.05.

Results

Fifty-four patients with suspected CAD who underwent both CCTA and serum Lp-PLA2 and MMP9 measurements were evaluated. Patients in the stenosis/plaque group had a significantly higher LpPLA2 and MMP-9 than the control group. Lp-PLA2 is positively associated with MMP-9 and MMP-9 with non-HDL. Except for Lp-PLA2 and CRP, sdLDL is associated with all assayed parameters. Lp-PLA2 and MMP-9 had 91.7% and 100% sensitivity in identifying patients with coronary plaque or stenosis at cutoff values of 183.34 and 24, respectively. MMP-9 and sdLDL-C had 100% and 92.9% specificity at cut-off values of 24 and 48.1.

Conclusions

By evaluating Lp-PLA2, MMP-9, sdLDL-C levels together with CT angiography findings, it is thought that these parameters can be used as an alternative to CT in controlling patients at risk and patients who have undergone cardiological intervention before.