European Heart Journal Advance Access originally published online on November 29, 2004
European Heart Journal 2005 26(2):137-144; doi:10.1093/eurheartj/ehi010
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European Heart Journal vol. 26 no. 2 © The European Society of Cardiology 2004; all rights reserved.
Association of lipoprotein-associated phospholipase A2 levels with coronary artery disease risk factors, angiographic coronary artery disease, and major adverse events at follow-up
1Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
2Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
3Division of Biostatistics, Mayo Clinic, Rochester, MN, USA
4Division of Cardiovascular Diseases, Duke Clinical Research Institute, Durham, NC 27715, USA
Received 20 April 2004; revised 1 August 2004; accepted 3 September 2004; online publish-ahead-of-print 29 November 2004.
* Corresponding author. Tel: +1 919 668 8355; fax: +1 919 668 7058. E-mail address: berger.peter{at}duke.edu
See page 107 for the editorial comment on this article (doi:10.1093/eurheartj/ehi042)
Aims We aimed to evaluate the association of lipoprotein-associated phospholipase A2 (Lp-PLA2) with coronary artery disease (CAD) risk factors, with the severity of angiographic CAD, and with the incidence of major adverse events.
Methods and results We measured Lp-PLA2 levels in 504 consecutive patients undergoing clinically indicated coronary angiography. Mean age was 60±11 years and 38% were women. The mean (±SD) Lp-PLA2 level (ng/mL) was 245±91. Lp-PLA2 levels correlated with male gender, LDL, HDL, and total cholesterol, fibrinogen, and creatinine. Lp-PLA2 levels correlated with the extent of angiographic CAD on univariate but not on multivariable analysis. During a median follow-up of 4.0 years, 72 major adverse events occurred in 61 of 466 (13%) contacted patients (20 deaths, 14 myocardial infarctions, 28 coronary revascularizations, and 10 strokes). Higher Lp-PLA2 levels were associated with a greater risk of events: the hazard ratio per SD was 1.28 (95% CI 1.06–1.54, P=0.009), and remained significant after adjusting for clinical and lipid variables and C-reactive protein.
Conclusion Higher Lp-PLA2 levels were associated with a higher incidence of major adverse events at follow-up, independently of traditional CAD risk factors and C-reactive protein.
Key Words: Lipoprotein-associated phospholipase A2 • C-reactive protein • Acute myocardial infarction • Coronary disease
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