Lipoprotein-Associated Phospholipase A2 Activity Is Associated With Risk of Coronary Heart Disease and Ischemic Stroke The Rotterdam Study

• Published in: Circulation (New York, N.Y.) Vol. 111; no. 5; pp. 570 - 575
• Main Authors: Oei, Hok-Hay S., van der Meer, Irene M., Hofman, Albert, Koudstaal, Peter J., Stijnen, Theo, Breteler, Monique M.B., Witteman, Jacqueline C.M.
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 08.02.2005
• Subjects: 1-Alkyl-2-acetylglycerophosphocholine Esterase; Aged; Biological and medical sciences; Blood and lymphatic vessels; Brain Ischemia - diagnosis; Brain Ischemia - epidemiology; Cardiology. Vascular system; Cholesterol - blood; Cohort Studies; Coronary Disease - diagnosis; Coronary Disease - epidemiology; Coronary heart disease; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; General aspects; Heart; Humans; Male; Medical sciences; Middle Aged; Phospholipases A - metabolism; Phospholipases A2; Risk Factors; Stroke - diagnosis; Stroke - epidemiology; Vertebrates: cardiovascular system; Cerebral infarction; Nervous system diseases; Stroke; Enzyme; Cardiovascular disease; Esterases; Inflammation; Lipoprotein; Coronary heart disease; Epidemiology; Phospholipase A; Carboxylic ester hydrolases; Cerebral disorder; Vascular disease; coronary disease; Central nervous system disease; Risk factor; Hydrolases; Cerebrovascular disease
• ISSN: 0009-7322; 1524-4539; 1524-4539
• DOI: 10.1161/01.CIR.0000154553.12214.CD

Background— Lipoprotein-associated phospholipase A2 (Lp-PLA2) has been proposed as an inflammatory marker of cardiovascular disease. In the present study, we investigated whether Lp-PLA2 is an independent predictor of coronary heart disease and ischemic stroke. Methods and Results— The Rotterdam Study is a population-based follow-up study in 7983 subjects ≥55 years of age. We performed a case-cohort study, including 308 coronary heart disease cases, 110 ischemic stroke cases, and a random sample of 1820 subjects. We used Cox proportional-hazard models with modification of the standard errors based on robust variance estimates to compute hazard ratios adjusted for age, sex, body mass index, systolic blood pressure, non-HDL cholesterol, HDL cholesterol, diabetes, smoking, alcohol consumption, cholesterol-lowering medication, white blood cell count, and C-reactive protein. Compared with the first quartile of Lp-PLA2 activity, multivariate-adjusted hazard ratios for coronary heart disease for the second, third, and fourth quartiles were 1.39 (95% CI, 0.92 to 2.10), 1.99 (95% CI, 1.32 to 3.00), and 1.97 (95% CI, 1.28 to 3.02), respectively ( P for trend=0.01). Corresponding multivariate-adjusted hazard ratios for ischemic stroke were 1.08 (95% CI, 0.55 to 2.11), 1.58 (95% CI, 0.82 to 3.04), and 1.97 (95% CI, 1.03 to 3.79) ( P for trend=0.03). The relation between Lp-PLA2 and coronary heart disease was present in both subjects with non-HDL cholesterol levels below the median and those with non-HDL cholesterol levels above the median. Conclusions— This study shows that Lp-PLA2 activity is an independent predictor of coronary heart disease and ischemic stroke in the general population.