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Cardiovascular Research 2000 47(1):159-165; doi:10.1016/S0008-6363(00)00060-2
© 2000 by European Society of Cardiology
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Copyright © 2000, European Society of Cardiology

Increase in plasma levels of secretory type II phospholipase A2 in patients with coronary spastic angina

Kiyotaka Kugiyama*, Yasutaka Ota, Hiroaki Kawano, Hirofumi Soejima, Hisao Ogawa, Seigo Sugiyama, Hideki Doi and Hirofumi Yasue

Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan

* Corresponding author. Tel.: +81-963-735-175; fax: +81-963-623-256 kiyo{at}gpo.kumamoto-u.ac.jp

Objective: Plasma levels of sPLA2 were increased in various chronic inflammatory diseases including coronary artery disease. Lipid products mediated through PLA2 have been shown to induce impairment of endothelium-dependent dilation, contraction of smooth muscle and proliferation of smooth muscle cells, all of which might lead to coronary spasm. Thus, this study investigated whether plasma levels of secretory non-pancreatic type II phospholipase A2 (sPLA2) may be increased in patients with coronary spastic angina, considering the possible link of sPLA2 with pathogenesis of coronary artery spasm. Methods: Plasma levels of sPLA2 in peripheral circulation, in coronary sinus and in aortic root were measured in 57 patients with coronary spastic angina, 46 patients with stable effort angina and 53 control patients by radioimmunoassay. Results: The peripheral plasma levels of sPLA2 were increased in patients with coronary spastic angina compared with control patients. In multivariate statistical analysis, the increase in sPLA2 levels was a significant risk for the presence of coronary spasm independent of other risk factors including C-reactive protein levels. The coronary sinus–arterial difference of plasma sPLA2 levels, reflecting sPLA2 released into the coronary circulation, was increased during coronary spasm induced by the intracoronary infusion of acetylcholine in patients with coronary spastic angina, but it remained unchanged both during the acetylcholine infusion and during myocardial ischemia provoked by rapid atrial pacing in patients with stable effort angina and in control patients. Conclusion: The increase in peripheral plasma levels of sPLA2 is a significant risk factor for the presence of coronary spasm and it may possibly reflect inflammatory activity in spasm coronary arteries.

KEYWORDS Acetylcholine; Atherosclerosis; Coronary disease; Infection/inflammation; Vasoconstriction/dilation


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