Link between lipoprotein-associated phospholipase A2 gene expression of peripheral-blood mononuclear cells and prognostic outcome after acute ischemic stroke

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.