title: Lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) and risk of cardiovascular disease in older adults: results from the Cardiovascular Health Study.
abstract: OBJECTIVE
  To examine associations between lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) antigen level (mass) and enzymatic activity (activity) and cardiovascular disease (CVD) in older adults.
  
  
  METHODS
  We examined associations of Lp-PLA(2) mass and activity with incident myocardial infarction (MI; n=508), stroke (n=565) and CVD death (n=665) using Cox regressions adjusted for age, sex, ethnicity and CVD risk factors in 3949 older adults, aged > or =65 years at baseline, from the Cardiovascular Health Study (CHS).
  
  
  RESULTS
  Lp-PLA(2) was associated with incident CVD events in these older adults. Hazard ratios (95% confidence intervals) for highest versus lowest tertiles of Lp-PLA(2) mass were 1.49 (1.19-1.85) for MI, 1.21 (0.98-1.49) for stroke and 1.11 (0.92-1.33) for CVD death. The highest tertile of Lp-PLA(2) activity was associated with MI (1.36; 1.09-1.70) and CVD death (1.23; 1.02-1.50). Combined Lp-PLA(2) tertile 3 and CRP>3mg/l, compared to Lp-PLA(2) tertile 1 and CRP<1mg/l, was associated with MI (2.29; 1.49-3.52) for Lp-PLA(2) mass and MI (1.66; 1.10-2.51) and CVD death (1.57; 1.08-2.26) for activity. For MI, both mass and activity added excess risk to elevated CRP alone ( approximately 20% excess risk) and activity added excess risk for CVD death ( approximately 12%).
  
  
  CONCLUSIONS
  Lp-PLA(2) mass and activity were associated with incident CVD events in older adults in CHS. Lp-PLA(2) and CRP were independent and additive in prediction of events. While associations were modest, these results support further exploration of Lp-PLA(2) to identify older individuals at risk for CVD.
authors.affiliation: Department of Pathology, College of Medicine, University of Vermont, Burlington, 208 South Park Drive, Colchester, VT 05446, United States. Nancy.Jenny@uvm.edu
authors.forename: Nancy Swords
authors.initials: NS
authors.lastname: Jenny
authors.forename: Cam
authors.initials: C
authors.lastname: Solomon
authors.forename: Mary
authors.initials: M
authors.lastname: Cushman
authors.forename: Russell P
authors.initials: RP
authors.lastname: Tracy
authors.forename: Jeanenne J
authors.initials: JJ
authors.lastname: Nelson
authors.forename: Bruce M
authors.initials: BM
authors.lastname: Psaty
authors.forename: Curt D
authors.initials: CD
authors.lastname: Furberg
mesh_terms: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000097:blood*; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology*; D005260:Female; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology; D011159:Population Surveillance; D011446:Prospective Studies; D012306:Risk; D020521:Stroke / Q000209:etiology
chemical_list: D002097:C-Reactive Protein; D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase