Abstract:Objective: Lipoprotein associated phospholipase A2 (Lp-PLA2) is one of the markers of cardiovascular inflammation, but the quantitative assessment of Lp-PLA2 levels in predicting the severity of coronary lesions is lacking. Methods: A total of 123 patients who underwent coronary angiography and Lp-PLA2 detection were enrolled to evaluate Lp-PLA2 level in predicting acute coronary syndrome (ACS), multi-vessel lesions and SYNTAXII score. Results: Lp-PLA2 was correlated with the diagnosis of coronary artery disease, multi-vessel lesions and SYNTAX II score (all P<0.05). Lp-PLA2 had high sensitivity in predicting ACS (90.9%) and multi-vessel lesions (80%) and high specificity in predicting SYNTAX II score ≥23 (81.7%) and ≥33 (87.4%). Lp-PLA2 was an independent risk factor for multi-vessel lesions and SYNTAX II score ≥23 and ≥33 (OR=1.004, 1.003 and 1.004, respectively, all P<0.05). Subgroup analysis showed that the higher concentration of Lp-PLA2 predicted the higher risk of multi-vessel lesions in hypertension (OR=2.800, P <0.05) and higher risk of SYNTAX II score ≥23 in hypertension and diabetes patients (OR=3.586 and 18.000, respectively, both P <0.05). Conclusion: Lp-PLA2 can effectively predict the severity of coronary lesions, especially the sensitivity of ACS diagnosis and multi-vessel lesions and the specificity of SYNTAXII score ≥23 and ≥33. The predictive value of Lp-PLA2 for coronary lesions is greater in hypertension and diabetes patients.