title: Circulating secretory phospholipase A2 activity and risk of incident coronary events in healthy men and women: the EPIC-Norfolk study.
abstract: OBJECTIVE
  To assess the association between secretory phospholipase A2 (sPLA2) activity, which encompasses several types of sPLA2, and cardiovascular disease (CAD) in healthy individuals.
  
  
  RESULTS
  We investigated this association in a nested case-control study among the 25,663 participants in EPIC-Norfolk cohort. Cases (n=991) were subjects in whom CAD developed during the 6 years of mean follow-up. Controls (n=1806) matched by age, sex, and enrollment time remained free of any CAD during follow-up. The risk of incident CAD was associated with increasing quartiles of sPLA2 activity (P<0.001). After adjustment for risk factors, C-reactive protein and sPLA2 type IIA concentration, the odds ratios of incident CAD in the second, third, and fourth quartiles of sPLA2 activity were 1.41, 1.33, and 1.56 (P=0.003), compared with the lowest quartile. sPLA2 activity and CRP were poorly correlated (r=0.15), and their combined values were more informative for incident risk of CAD than either biomarker alone. Subjects in the highest quartiles of sPLA2 activity and CRP had an adjusted odds ratio of 2.89 (95% confidence interval, 1.78 to 4.68; P<0.001) for CAD compared with those with the lowest quartiles of both markers.
  
  
  CONCLUSIONS
  Measurement of serum sPLA2 activity provides additive prognostic value to traditional risk factors and CRP levels, and identifies a subgroup of individuals at high risk for incident CAD. Measurement of sPLA2 type II concentration had little added prognostic utility.
authors.affiliation: Inserm U689, Centre de Recherche Cardiovasculaire Lariboisière, Paris, France. ziad.mallat@larib.inserm.fr
authors.forename: Ziad
authors.initials: Z
authors.lastname: Mallat
authors.forename: Joelle
authors.initials: J
authors.lastname: Benessiano
authors.forename: Tabassome
authors.initials: T
authors.lastname: Simon
authors.forename: Stéphane
authors.initials: S
authors.lastname: Ederhy
authors.forename: Carla
authors.initials: C
authors.lastname: Sebella-Arguelles
authors.forename: Ariel
authors.initials: A
authors.lastname: Cohen
authors.forename: Virginie
authors.initials: V
authors.lastname: Huart
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Wareham
authors.forename: Robert
authors.initials: R
authors.lastname: Luben
authors.forename: Kay-Tee
authors.initials: KT
authors.lastname: Khaw
authors.forename: Alain
authors.initials: A
authors.lastname: Tedgui
authors.forename: S Matthijs
authors.initials: SM
authors.lastname: Boekholdt
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D003327:Coronary Disease / Q000097:blood* / Q000453:epidemiology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005470:Fluorometry; D005500:Follow-Up Studies; D054501:Group II Phospholipases A2; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010741:Phospholipases A / Q000097:blood*; D054467:Phospholipases A2; D011379:Prognosis; D012016:Reference Values; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D010741:Phospholipases A; D054501:Group II Phospholipases A2; D054467:Phospholipases A2