AUTHOR=Qin Yiren , Qian Xiaoyan , Luo Xue , Li Yuanfang , Wang Dapeng , Jiang Jianhua , Zhang Quanquan , Liu Meirong , Xiao Junhua , Zhang Yan , Diao Shanshan , Zhao Hongru 

TITLE=Association Between Plasma Lipoprotein-Associated Phospholipase A2 and Plaque Vulnerability in TIA Patients With Unilateral Middle Cerebral Artery Stenosis

JOURNAL=Frontiers in Neurology

VOLUME=Volume 11 - 2020

YEAR=2020

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2020.574036

DOI=10.3389/fneur.2020.574036

ISSN=1664-2295

ABSTRACT=Background Plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) has emerged as a novel biomarker for coronary atherosclerosis. However, the association between Lp-PLA2 and plaque vulnerability in atherosclerosis of cervicocerebral arteries remains poorly defined, especially for intracranial atherosclerotic stenosis (ICAS). We aimed to investigate the association between Lp-PLA2 and plaque vulnerability in transient ischemic attack (TIA) patients with unilateral middle cerebral artery stenosis (MCAs).
Methods In this study, a total of 207 patients were enrolled from April 2017 to April 2020. Clinical data were collected and MCA plaques were examined with high-resolution magnetic resonance imaging (HRMRI). Baseline characteristics of patients were collected during hospitalization. Statistical comparisons were performed using Pearson's chi-squared test, Mann Whitney U test, and the Breslow-Day/Tarone's test for the determination of heterogeneity in different age strata. Multivariate binary logistic analysis was used to investigate the potential independent predictors that were highly correlated to plaque vulnerability. 
Results The results showed that a high Lp-PLA2 level (>221 ng/mL) was associated with plaque vulnerability in TIA patients with unilateral MCAs. High Lp-PLA2 was independently associated with plaque vulnerability in patients ≤ 60 years old (Multivariate adjusted OR= 9.854, 95% CI 2.458-39.501) but not in patients > 60 years old (Multivariate adjusted OR= 1.901, 95% CI 0.640-5.650). Predictors of plaque vulnerability in different age strata were also different.
Conclusion Lp-PLA2 levels may be correlated to plaque vulnerability in TIA patients with unilateral MCAs, and might be a diagnostic biomarker for plaque vulnerability in this kind of patients, especially for ones aged ≤ 60 years old.