Lipoprotein-associated phospholipase A2 and risk of incident cardiovascular disease in a multi-ethnic cohort: The multi ethnic study of atherosclerosis

Abstract Objective Prospective studies reporting a positive association of lipoprotein-associated phospholipase A2 (Lp-PLA2 ) mass and activity with incident cardiovascular disease (CVD) have included primarily white individuals. We evaluated associations of Lp-PLA2 and first-time cardiovascular eve...

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Bibliographic Details
Published in:Atherosclerosis 2015-07, Vol.241 (1), p.176-182
Main Authors: Garg, Parveen K, McClelland, Robyn L, Jenny, Nancy S, Criqui, Michael H, Greenland, Philip, Rosenson, Robert S, Siscovick, David S, Jorgensen, Neal, Cushman, Mary
Format: Article
Language:English
Subjects:
1-Alkyl-2-acetylglycerophosphocholine Esterase - blood
Aged
Aged, 80 and over
Biomarker
Biomarkers - blood
Cardiovascular
Cardiovascular disease
Cardiovascular Diseases - blood
Cardiovascular Diseases - diagnosis
Cardiovascular Diseases - enzymology
Cardiovascular Diseases - ethnology
Cardiovascular Diseases - mortality
Carotid Artery Diseases - blood
Carotid Artery Diseases - enzymology
Carotid Artery Diseases - epidemiology
Carotid Intima-Media Thickness
Coronary Angiography
Coronary Artery Disease - blood
Coronary Artery Disease - enzymology
Coronary Artery Disease - epidemiology
Ethnicity
Female
Humans
Incidence
Inflammation
Linear Models
Lipoprotein-associated phospholipase A2
Male
Middle Aged
Prognosis
Proportional Hazards Models
Prospective Studies
Risk Factors
Time Factors
United States - epidemiology
Up-Regulation
Vascular Calcification - blood
Vascular Calcification - enzymology
Vascular Calcification - epidemiology
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Summary:Abstract Objective Prospective studies reporting a positive association of lipoprotein-associated phospholipase A2 (Lp-PLA2 ) mass and activity with incident cardiovascular disease (CVD) have included primarily white individuals. We evaluated associations of Lp-PLA2 and first-time cardiovascular events in a healthy multi-ethnic cohort characterized by presence or absence of baseline subclinical atherosclerosis. Methods Lp-PLA2 mass and activity were measured at baseline in 5456 participants in the Multi-Ethnic Study of Atherosclerosis. Individuals were characterized for presence of baseline subclinical disease (coronary artery calcium score > 0 or carotid intima-media thickness value > 80th percentile) and followed prospectively for development of CVD events (coronary heart disease, ischemic stroke, and cardiovascular death). Results 516 incident CVD events occurred over median follow-up of 10.2 years. In adjusted Cox proportional hazards models, each higher standard deviation of both Lp-PLA2 activity and mass was associated with an increased risk of cardiovascular events; hazard ratios (HR; 95% confidence intervals (CI)) 1.12 (1.01–1.26) for Lp-PLA2 activity and 1.10 (1.01–1.21) for mass. Associations did not differ by subclinical disease status (p-value for interaction 0.99 for Lp-PLA2 activity and 0.32 for Lp-PLA2 mass) and there was no confounding by subclinical atherosclerosis measures. Associations of Lp-PLA2 activity but not mass were weaker in Chinese participants but there were relatively few events among Chinese in race-stratified analysis. Conclusion In this multi-ethnic cohort, Lp-PLA2 was positively associated with CVD risk, regardless of the presence of coronary artery calcium or a thickened carotid-intimal media.
ISSN:0021-9150
1879-1484
DOI:10.1016/j.atherosclerosis.2015.05.006