Lipoprotein-associated phospholipase A2 activity and risk of heart failure: The Rotterdam study.
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.
van Vark
Laura C
LC
Department of Epidemiology and Biostatistics, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
Kardys
Isabella
I
Bleumink
Gysèle S
GS
Knetsch
Anneke M
AM
Deckers
Jaap W
JW
Hofman
Albert
A
Stricker
Bruno H Ch
BH
Witteman
Jacqueline C M
JC
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
D054467:Phospholipases A2; D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase