CONTINUING EDUCATION :: CARDIAC BIOMARKERS


-llA—the next step to enhancing your cardiac testing panel


sPLA2 By Rebecca Kirby C


ardiovascular disease (CVD) is the number one cause of death globally, with an estimated 17.7 mil- lion people dying each year. This figure represents approximately 31 percent of all global deaths.1


Worry-


ingly, this figure is set to increase to over 23.6 million by 2030. These startling statistics highlight the urgent need for better and earlier identification of at-risk individuals; this is especially true as many CVD cases can be prevented with appropriate lifestyle changes. This article will discuss the utility of sPLA2


risk assessment. Traditional and routinely run biomarkers


-llA, a novel biomarker for use in CVD for


-llA has been proven to have clinical utility as a biomarker of inflammation. Inflammation is a process by which the body launches an attack utilizing our white blood cells. This response results in redness and swell- ing to either eliminate the pathogen or rid the body of an intruder.2,3


Inflammation is a common response in


many disease states, in some cases the body’s immune system triggers an inflammatory response when there are no invaders to fight off. Inflammation is also associated with CVD. Although not a direct cause of CVD, inflam- mation is common in heart disease and stroke patients and is thought to be a sign of an atherogenic response. It is believed that in CVD the body perceives the plaque as abnormal or foreign and in response the body tries to prevent the plaque from entering the blood.3


However, in


some circumstances, the plaque may rupture and come in contact with the blood triggering clot formation.3


Earning CEUs


See test on page 14 or online at www.mlo-online.com under the CE Tests tab. LEARNING OBJECTIVES


Upon completion of this article, the reader will be able to:


1. Discuss disease and mortality statistics of cardiovascular disease (CVD).


2. Recall the new biomarker being studied for CVD and its utility in early risk assessment.


3. Describe the chemical process by which sPLA2- coronary artery wall.


4. Discuss other diseases that sPLA2 8 JUNE 2019 MLO-ONLINE.COM -llA acts on the -llA is being used on. Figure 1: Inflammation5


CVD risk include lipid assays such as Total Choles- terol, HDL Cholesterol (HDL-C), LDL Cholesterol (LDL- C), and Triglycerides. There is, however, a growing body of research and evidence indicating that additional risk assessment biomarkers need to be considered. Conven- tional risk assessment markers like those mentioned previ- ously detect a mere 20 percent of all CVD patients. As the prevalence of CVD continues to rise worldwide, the need for reliable risk markers has never been more important. sPLA2


Early risk assessment helps to reduce the risk of a car- diac event occurring. Identifying those at highest risk of CVD and ensuring they receive appropriate treatment can prevent premature death.4


Early risk assessment is


particularly important in people who present with one or more risk factors including hypertension, diabetes, or hyperlipidemia. As stated before, by 2030 it is estimated that almost 23.6 million people will die from CVD, with heart disease and stroke projected to remain the leading causes of death.4


This provides further confirmation that


early diagnosis is an essential step in reducing the number of individuals affected.


The financial burden that CVD places on health ser- vices makes the development of a diagnostic biomarker even more essential. sPLA2 phospholipase A2


-llA, a member of the secretory


utility as an inflammation biomarker specifically in the diagnosis of CVD risk. The addition of sPLA2


family, has been found to have clinical -llA could


compliment the labs existing cardiac risk panel, provid- ing a different outlook and method of assessing cardiac concerns in patients.


Biological significance The phospholipase A2


family encompasses a wide range


of enzymes that are all capable of hydrolyzing the sn-2 ester bond of a natural phospholipid substrate. This reac- tion produces lysophospholipids and free fatty acids. Despite similar structural features, catalytic mechanisms, and evolutionary relationships, the superfamily of PLA2


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