Lipoprotein-associated phospholipase A2 as a biomarker of coronary heart disease and a therapeutic target

Purpose of review Lipoprotein-associated phospholipase A(2) (Lp PLA(2)) is postulated to occupy a key position in the pathogenic sequence leading to formation of complex atherosclerotic lesions. This study reviews evidence supporting its role as a biomarker of vascular disease and as a possible therapeutic target. Recent findings Evidence continues to build supporting the usefulness of Lp PLA(2) as a predictor of coronary events in the general population and in those with established coronary heart disease. Elevated Lp PLA(2) is also associated with stroke and heart failure. The crystal structure of Lp PLA(2) is now available and offers insight into the links between structure, function and atherogenic properties. Recently completed studies on the efficacy of darapladib, a specific Lp PLA(2) inhibitor, show beneficial changes in plaque morphology in animal models and in humans. Summary Lp PLA(2) is gaining acceptance as a useful biomarker of chronic inflammation and as a predictor of vascular disease. Early results with darapladib offer promise, but not definitive proof, of a potential role for Lp PLA(2) inhibition in coronary heart disease prevention.