{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T03:51:11Z","timestamp":1779249071183,"version":"3.51.4"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2012,2,14]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>\n              Secretory phospholipase A2 (sPLA\n              <jats:sub>2<\/jats:sub>\n              ) and lipoprotein-associated phospholipase A2 (Lp-PLA\n              <jats:sub>2<\/jats:sub>\n              ) are enzyme biomarkers of increased cardiovascular risk and targets of emerging therapeutic agents. Their relationship to cardiovascular events in the setting of high-dose statin therapy compared with placebo in patients with acute coronary syndrome is not known.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              sPLA\n              <jats:sub>2<\/jats:sub>\n              and Lp-PLA\n              <jats:sub>2<\/jats:sub>\n              mass and activity were measured in 2587 patients in the Myocardial Ischemia Reduction With Acute Cholesterol Lowering (MIRACL) trial at baseline and after 16 weeks of treatment with atorvastatin 80 mg\/d or placebo. Baseline levels of sPLA\n              <jats:sub>2<\/jats:sub>\n              and Lp-PLA\n              <jats:sub>2<\/jats:sub>\n              mass and activity were not associated with the primary efficacy measure of the trial of death, myocardial infarction, or unstable angina. However, in the overall cohort, baseline sPLA\n              <jats:sub>2<\/jats:sub>\n              mass predicted risk of death after multivariable adjustment (hazard ratio for 2-fold increase, 1.30; 95% confidence interval, 1.09\u20131.56;\n              <jats:italic>P<\/jats:italic>\n              =0.004). This association remained significant when examined separately in the placebo group but not in the atorvastatin group. Compared with placebo, atorvastatin reduced median sPLA\n              <jats:sub>2<\/jats:sub>\n              mass (\u221232.1% versus \u221223.1%), sPLA\n              <jats:sub>2<\/jats:sub>\n              activity (\u221229.5% versus \u221219.2%), Lp-PLA\n              <jats:sub>2<\/jats:sub>\n              mass (\u221235.8% versus \u22126.2%), and Lp-PLA\n              <jats:sub>2<\/jats:sub>\n              activity (\u221224.3% versus 5.4%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001 for all). Atorvastatin reduced the hazard of death associated with elevated sPLA\n              <jats:sub>2<\/jats:sub>\n              mass and activity by \u224850%.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>\n              sPLA\n              <jats:sub>2<\/jats:sub>\n              mass independently predicts death during a 16-week period after acute coronary syndrome. High-dose atorvastatin significantly reduces sPLA\n              <jats:sub>2<\/jats:sub>\n              and Lp-PLA\n              <jats:sub>2<\/jats:sub>\n              mass and activity after acute coronary syndrome and mitigates the risk of death associated with sPLA\n              <jats:sub>2<\/jats:sub>\n              mass. Atorvastatin may exert antiinflammatory effects on phospholipases that contribute to its therapeutic benefit after acute coronary syndrome.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.111.063487","type":"journal-article","created":{"date-parts":[[2012,1,10]],"date-time":"2012-01-10T03:54:37Z","timestamp":1326167677000},"page":"757-766","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":48,"title":["Phospholipase A\n            <sub>2<\/sub>\n            Enzymes, High-Dose Atorvastatin, and Prediction of Ischemic Events After Acute Coronary Syndromes"],"prefix":"10.1161","volume":"125","author":[{"given":"Sung Kee","family":"Ryu","sequence":"first","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, Seoul Eulji Hospital, Eulji University, School of Medicine, Seoul, Republic of Korea (S.K.R.); Department of Medicine, University of Cambridge, Cambridge, UK (Z.M.); INSERM U 970, Paris Cardiovascular Research Center, Paris-Descartes University, Paris, France (Z.M., J.B., A.T.); Department of Medicine and Care, Faculty of Health Sciences, University of Link\u00f6ping and Stockholm Heart Center, Link\u00f6ping, Sweden (A.G.O.); Pfizer, Inc, New..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ziad","family":"Mallat","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, Seoul Eulji Hospital, Eulji University, School of Medicine, Seoul, Republic of Korea (S.K.R.); Department of Medicine, University of Cambridge, Cambridge, UK (Z.M.); INSERM U 970, Paris Cardiovascular Research Center, Paris-Descartes University, Paris, France (Z.M., J.B., A.T.); Department of Medicine and Care, Faculty of Health Sciences, University of Link\u00f6ping and Stockholm Heart Center, Link\u00f6ping, Sweden (A.G.O.); Pfizer, Inc, New..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joelle","family":"Benessiano","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, Seoul Eulji Hospital, Eulji University, School of Medicine, Seoul, Republic of Korea (S.K.R.); Department of Medicine, University of Cambridge, Cambridge, UK (Z.M.); INSERM U 970, Paris Cardiovascular Research Center, Paris-Descartes University, Paris, France (Z.M., J.B., A.T.); Department of Medicine and Care, Faculty of Health Sciences, University of Link\u00f6ping and Stockholm Heart Center, Link\u00f6ping, Sweden (A.G.O.); Pfizer, Inc, New..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alain","family":"Tedgui","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, Seoul Eulji Hospital, Eulji University, School of Medicine, Seoul, Republic of Korea (S.K.R.); Department of Medicine, University of Cambridge, Cambridge, UK (Z.M.); INSERM U 970, Paris Cardiovascular Research Center, Paris-Descartes University, Paris, France (Z.M., J.B., A.T.); Department of Medicine and Care, Faculty of Health Sciences, University of Link\u00f6ping and Stockholm Heart Center, Link\u00f6ping, Sweden (A.G.O.); Pfizer, Inc, New..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anders G.","family":"Olsson","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, Seoul Eulji Hospital, Eulji University, School of Medicine, Seoul, Republic of Korea (S.K.R.); Department of Medicine, University of Cambridge, Cambridge, UK (Z.M.); INSERM U 970, Paris Cardiovascular Research Center, Paris-Descartes University, Paris, France (Z.M., J.B., A.T.); Department of Medicine and Care, Faculty of Health Sciences, University of Link\u00f6ping and Stockholm Heart Center, Link\u00f6ping, Sweden (A.G.O.); Pfizer, Inc, New..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weihang","family":"Bao","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, Seoul Eulji Hospital, Eulji University, School of Medicine, Seoul, Republic of Korea (S.K.R.); Department of Medicine, University of Cambridge, Cambridge, UK (Z.M.); INSERM U 970, Paris Cardiovascular Research Center, Paris-Descartes University, Paris, France (Z.M., J.B., A.T.); Department of Medicine and Care, Faculty of Health Sciences, University of Link\u00f6ping and Stockholm Heart Center, Link\u00f6ping, Sweden (A.G.O.); Pfizer, Inc, New..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory G.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, Seoul Eulji Hospital, Eulji University, School of Medicine, Seoul, Republic of Korea (S.K.R.); Department of Medicine, University of Cambridge, Cambridge, UK (Z.M.); INSERM U 970, Paris Cardiovascular Research Center, Paris-Descartes University, Paris, France (Z.M., J.B., A.T.); Department of Medicine and Care, Faculty of Health Sciences, University of Link\u00f6ping and Stockholm Heart Center, Link\u00f6ping, Sweden (A.G.O.); Pfizer, Inc, New..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sotirios","family":"Tsimikas","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, Seoul Eulji Hospital, Eulji University, School of Medicine, Seoul, Republic of Korea (S.K.R.); Department of Medicine, University of Cambridge, Cambridge, UK (Z.M.); INSERM U 970, Paris Cardiovascular Research Center, Paris-Descartes University, Paris, France (Z.M., J.B., A.T.); Department of Medicine and Care, Faculty of Health Sciences, University of Link\u00f6ping and Stockholm Heart Center, Link\u00f6ping, Sweden (A.G.O.); Pfizer, Inc, 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