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Originally published In Press as doi:10.1194/jlr.M300086-JLR200 on May 1, 2003

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Journal of Lipid Research, Vol. 44, 1381-1386, July 2003
Copyright © 2003 by American Society for Biochemistry and Molecular Biology

Plasma PAF-acetylhydrolase in patients with coronary artery disease

: results of a cross-sectional analysis

Stefan Blankenberg*,{dagger}, Dominique Stengel*, Hans J. Rupprecht{dagger}, Christoph Bickel{dagger}, Jürgen Meyer{dagger}, François Cambien*, Laurence Tiret* and Ewa Ninio1,*

* INSERM U525/IFR14 Coeur Muscle Vaisseaux and Université P. M. Curie/Faculté de Médecine Pitié-Salpétrière, Paris, France
{dagger} Department of Medicine II, Johannes Gutenberg-University Mainz, Germany

1 To whom correspondence should be addressed. e-mail: ninio{at}chups.jussieu.fr

Inflammation underlies both onset and perpetuation of atherosclerosis. Plasma lipoproteins transport the platelet-activating factor-acetylhydrolase (PAF-AH) with potentially anti-inflammatory activities. Our aim was to determine whether PAF-AH activity was associated with inflammatory markers and with coronary artery disease (CAD). PAF-AH activity and a panel of inflammatory mediators were measured in plasma of 496 patients with CAD and in 477 controls; 276 patients presented with stable angina pectoris and 220 with acute coronary syndrome (ACS). Individuals within the highest quartile of PAF-AH activity had an 1.8-fold increase in CAD risk [95% confidence interval (CI), 1.01 to 3.2; P = 0.048] compared with those in the first quartile (adjusted for clinical and metabolic factors). When excluding individuals receiving statin and angiotensin-converting enzyme-inhibitor medication, individuals within the highest quartile of PAF-AH activity revealed a 3.9-fold increase in CAD risk (95% CI, 2.0 to 7.7; P < 0.0001). In these subjects, the plasma PAF-AH activity increased gradually in stable angina and in ACS both in men (P < 0.0001) and in women (P < 0.001), as compared with controls.

No correlation was found between PAF-AH levels and those of common markers of inflammation. This study and the previous ones raise the important issue of whether PAF-AH is simply a marker of risk or directly promotes atherosclerosis.

Abbreviations: ACS, acute coronary syndrome; CI, confidence interval; CRP, C-reactive protein; IL-6, interleukin-6; OR, odds ratio; PAF-AH, platelet-activating factor-acetylhydrolase; SAP, stable angina pectoris

Supplementary key words inflammation • atherosclerosis • platelet-activating factor


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