High lipoprotein-associated phospholipase A2 is a risk factor for recurrent coronary events in postinfarction patients.
BACKGROUND
Recent studies demonstrate that lipoprotein-associated phospholipase A2 (Lp-PLA2) is a risk factor for cardiovascular disease presumably deriving from generation of proinflammatory and proatherogenic species through its hydrolytic activity on lipoprotein-associated phospholipids. The goal of this study was to assess the relationship of Lp-PLA2 with a set of thrombogenic, lipid, inflammatory, and metabolic blood markers and to determine whether plasma Lp-PLA2 is a risk factor for recurrent coronary events in postinfarction patients.


METHODS
Factor analysis on the set of blood markers and Lp-PLA2 was performed for 766 patients of the Thrombogenic Factors and Recurrent Coronary Events (THROMBO) postinfarction study. Recurrent coronary event risk was assessed as a function of blood marker concentrations and Lp-PLA2 by Cox proportional hazards multivariable regression adjusted for significant clinical covariates.


RESULTS
Factor analysis revealed that Lp-PLA2 was associated with one factor dominated by cholesterol and apolipoprotein B and another factor dominated by HDL-cholesterol and triglycerides, with little association with an inflammatory factor dominated by C-reactive protein. Multivariable analysis demonstrated as significant and independent predictors of risk of secondary coronary events only apolipoprotein B in a model without Lp-PLA2 (hazard ratio, 1.66; 95% confidence interval, 1.14-2.40) and only Lp-PLA2 in a model with Lp-PLA2 included [1.90 (1.31-2.75)].


CONCLUSIONS
Lp-PLA2 is a significant and independent predictor of risk for recurrent coronary events in postinfarction patients, and Lp-PLA2 is related to both hypercholesterolemia and high triglyceride-low HDL dyslipidemia in this study population.
Corsetti
James P
JP
Department of Pathology and Laboratory Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA. James_Corsetti@urmc.rochester.edu
Rainwater
David L
DL
Moss
Arthur J
AJ
Zareba
Wojciech
W
Sparks
Charles E
CE
D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase; D000789:Angina, Unstable / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D003327:Coronary Disease / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D015228:Hypertriglyceridemia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000453:epidemiology*; D010741:Phospholipases A / Q000097:blood*; D054467:Phospholipases A2; D016016:Proportional Hazards Models; D012008:Recurrence; D012307:Risk Factors; D016019:Survival Analysis
D015415:Biomarkers; D010741:Phospholipases A; D054467:Phospholipases A2; D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase