Secretory Phospholipase A2 Activity Tied to Increased Risk of Ischaemic Stroke

Pavankumar Kamat


July 19, 2021


  • Secretory phospholipase A2 (sPLA2) activity, but not concentration, was associated with an increased risk of future ischaemic stroke, independent of traditional cardiovascular (CV) risk factors.

Why this matters

  • Findings suggest that a greater understanding of enzymatic pathways associated with future stroke risk may help develop novel therapeutic agents.

Study design

  • A nested case-control study included 435 participants from the European Prospective Investigation into Cancer-Norfolk (EPIC-Norfolk) study.

  • 145 patients with ischaemic stroke (cases) during follow-up were matched (2:1) with 290 control participants.

  • The study was performed using both multiple imputation using chained equations (MICE) and complete-case analysis.

  • Funding: Medical Research Council and Cancer Research UK.

Key results

  • sPLA2 activity was associated with an increased risk of ischaemic stroke in both:

    • MICE analysis (adjusted OR [aOR], 1.20; 95% CI, 1.01-1.43); and

    • complete-case analysis (aOR, 1.23; 95% CI, 1.01-1.49).

  • sPLA2 concentration was not associated with an increased risk of ischaemic stroke (aOR, 1.02; 95% CI, 0.99-1.04) in both MICE and complete-case analysis.


  • Both cases and controls may have a higher prevalence of CV risk factors compared with the general population.

  • Possibility of residual confounding.


Smith JW, Barlas RS, Mamas MA, Boekholdt SM, Mallat Z, Luben RN, Wareham NJ, Khaw KT, Myint PK. Association between serum secretory phospholipase A2 and risk of ischemic stroke. Eur J Neurol. 2021 Jul 03 [Epub ahead of print]. doi: 10.1111/ene.15004. PMID: 34216520.  View abstract 

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.


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