Lipoprotein-associated phospholipase A2 (Lp-PLA2), also known as platelet activating factor acetylhydrolase, is an inflammatory enzyme that circulates bound mainly to low-density lipoproteins and has been found to be localized and enriched in atherosclerotic plaques. In multiple clinical trials, Lp-PLA2 activity has been shown to be an independent predictor of coronary heart disease and stroke in the general population. Measurement of Lp-PLA2 may be used along with traditional cardiovascular risk factor measures for identifying individuals at higher risk of cardiovascular disease events. Clinical management may include beginning or intensifying risk reduction strategies.
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What is the Lp-PLA2 Activity test?
The Lp-PLA2 Activity test measures the activity (or actions) of Lp-PLA2 in the bloodstream. Lp-PLA2 is an enzyme that can assess the amount of inflammation in your arteries due to a build-up of cholesterol.
Why should I get the Lp-PLA2 Activity test?
The Lp-PLA2 Activity test can help assess your risk for heart disease. When LDL cholesterol (the carrier of “bad” cholesterol) gets into your artery wall, the body tries to get rid of it by making Lp-PLA2. Unfortunately, the actions of Lp-PLA2 contribute to increased inflammation and increased cholesterol accumulation in the artery wall, forming what is called plaque. Inflammation can also make the cap covering the plaque thinner, which makes it more likely to rupture. The body responds to the rupture by forming a blood clot, which can block the flow of blood. If the blood flowing to the heart is blocked, it may cause a heart attack, while blocked blood flow to the brain may cause a stroke. In short, the Lp-PLA2 Activity test can help your medical provider better understand the health of your arteries and determine if you are actively growing plaque that is at risk for rupturing and developing a heart attack or stroke.
Sources:
https://www.knowyourrisk.com/wp-content/uploads/2016/05/Lp-PLA2_Activity_Handout.pdf
https://www.labcorp.com/tests/123283/lipoprotein-associated-phospholipase-a2-activity
References:
PLAC Test for Lp-PLA2 Activity to Predict Coronary Heart Disease, JENNIFER G. CHANG, MD, Uniformed Services University of the Health Sciences, Bethesda, Maryland - Am Fam Physician. 2020;101(1):44-46 [L]
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Lp-PLA2 activity is to be used in conjunction with clinical evaluation and patient risk assessment as an aid in predicting risk of coronary heart disease (CHD) in patients with no prior history of cardiovascular events.
Several lines of evidence suggest that oxidation of LDL plays a critical step in the development and progression of atherosclerosis.
Lp-PLA2 participates in the breakdown of oxidized LDL in the vascular wall by hydrolyzing the oxidized phospholipid, producing lysophosphatidylcholine and oxidized free fatty acids, both of which are potent pro-inflammatory products that contribute to the formation of atherosclerotic plaques.
What can I do to help lower my Lp-PLA2 Activity levels?
There are a number of things you can do to lower your overall risk of heart disease, as well as lowering your Lp-PLA2 Activity levels.
1. Adopt a heart-healthy diet by eating more vegetables, fruits, and whole grain foods and reducing the amount of fatty foods you eat.
2. Exercise more and on a consistent basis.
3. If you smoke, quit. It is not easy but there are programs and strategies (including over-the-counter and prescription medications) that can improve your chance of success. Talk with your medical provider to find what works best for you.
4. See your dentist as periodontal disease is a contributor to heart disease.
5. There are prescription and non-prescription medicines, as well as supplements, your medical provider can give you that reduce Lp-PLA2 Activity levels. Your medical provider will work with you to develop a treatment plan that is right for you to help reduce your risk of heart disease.
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%sdLDL-C, Apo B : Apo A-1, ApoA-I, Atherogenic index, Estimated CHD Risk, Fibrinogen, Glycomark (1 ,5-Anhydroglucitol), HDL-C, HDL-C/TG, hsCRP, IDL Cholesterol, LDL-C, LDL/HDL Cholesterol Ratio, Leptin : Adiponectin ratio, Myeloperoxidase (MPO), Non-HDL Cholesterol, Oxidized LDL, Oxidized LDL : LDL-C, OxLDL (Oxidized LDL), PLAC, PLAC (LP-PLA2 Activity), Small dense LDL Cholesterol, Small dense LDL-C : LDL-C, Total Cholesterol, Total Cholesterol/HDL Ratio, Triglycerides, Triglycerides to HDL Ratio, VLDL-C/TG, VLDL-C/TG (Boston Heart)
