title: Lipoprotein-associated phospholipase A2 activity and risk of heart failure: The Rotterdam study.
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  CONCLUSIONS
  This study suggests that Lp-PLA2 activity is independently associated with incident heart failure.
authors.affiliation: Department of Epidemiology and Biostatistics, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
authors.forename: Laura C
authors.initials: LC
authors.lastname: van Vark
authors.forename: Isabella
authors.initials: I
authors.lastname: Kardys
authors.forename: Gysèle S
authors.initials: GS
authors.lastname: Bleumink
authors.forename: Anneke M
authors.initials: AM
authors.lastname: Knetsch
authors.forename: Jaap W
authors.initials: JW
authors.lastname: Deckers
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Bruno H Ch
authors.initials: BH
authors.lastname: Stricker
authors.forename: Jacqueline C M
authors.initials: JC
authors.lastname: Witteman
mesh_terms: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000378:metabolism*; D017677:Age Distribution; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006333:Heart Failure / Q000201:enzymology* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D054467:Phospholipases A2; D016016:Proportional Hazards Models; D012307:Risk Factors; D017678:Sex Distribution; D016019:Survival Analysis
chemical_list: D054467:Phospholipases A2; D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase