Highlights
- •We evaluated associations of Lp-PLA2 and first-time cardiovascular events.
- •Participants comprised a multi-ethnic cohort characterized at baseline for subclinical disease.
- •Both Lp-PLA2 activity and mass were associated with incident cardiovascular events.
- •Associations of Lp-PLA2 activity were weaker in Chinese participants.
- •There was no confounding by subclinical atherosclerosis measures.
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.
Keywords
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Article info
Publication history
Published online: May 16, 2015
Accepted:
May 13,
2015
Received in revised form:
April 10,
2015
Received:
December 19,
2014
Identification
Copyright
© 2015 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.