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European Heart Journal Advance Access originally published online on September 4, 2006
European Heart Journal 2006 27(19):2346-2352; doi:10.1093/eurheartj/ehl230
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© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Lipoprotein-associated phospholipase A2 activity and risk of heart failure: the Rotterdam Study

Laura C. van Vark1, Isabella Kardys1, Gysèle S. Bleumink1,2, Anneke M. Knetsch1, Jaap W. Deckers3, Albert Hofman1, Bruno H.Ch. Stricker1 and Jacqueline C.M. Witteman1,*

1 Department of Epidemiology and Biostatistics, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
2 Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands
3 Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands

Received 16 March 2006; revised 8 April 2006; accepted 17 August 2006; online publish-ahead-of-print 4 September 2006.

* Corresponding author. Tel: +31 10 4087488; fax: +31 10 4089382. E-mail address: j.witteman{at}erasmusmc.nl

Aims Evidence is accumulating that inflammation plays a role in the pathophysiology of heart failure. Lipoprotein-associated phospholipase A2 (Lp-PLA2) has pro-inflammatory properties. We investigated whether Lp-PLA2 activity is associated with heart failure.

Methods and results Lp-PLA2 activity was determined in a random sample of 1820 subjects from the Rotterdam Study, a population-based cohort study among persons aged 55 years and over. During a mean follow-up of 6.7 years, 94 heart failure cases occurred. We excluded participants with heart failure or coronary heart disease at baseline and we accounted for incident coronary heart disease during follow-up. We used Cox proportional hazard models to compute hazard ratios adjusted for age, sex, non-HDL cholesterol, HDL cholesterol, body mass index, systolic blood pressure, diastolic blood pressure, hypertension, diabetes mellitus, smoking, and C-reactive protein. The hazard ratio per unit increase of Lp-PLA2 activity was 1.03 [95% confidence interval (95% CI 1.01–1.05]; P for trend was 0.011. Hazard ratios for the second, third, and fourth quartiles were 1.06 (95% CI 0.55–2.04), 1.43 (95% CI 0.73–2.81), and 2.33 (95% CI 1.21–4.49), respectively, using the lowest quartile of Lp-PLA2 activity as the reference category.

Conclusion This study suggests that Lp-PLA2 activity is independently associated with incident heart failure.

Key Words: Heart failure • Inflammation • Epidemiology


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