title: Association between lipoprotein associated phospholipase A2 mass and subclinical coronary and carotid atherosclerosis in Retired National Football League players.
abstract: OBJECTIVE
  Retired National Football League (NFL) players were reported to have high prevalence of cardiovascular risk factors. Lipoprotein Associated Phospholipase A2 (LpPLA2) has shown to be associated with cardiovascular disease in the general population, but it is unknown whether such an association exists in retired NFL players. Our objective was to assess whether LpPLA2 mass was associated with coronary artery calcium (CAC) and carotid artery plaque (CAP) in retired NFL players.
  
  
  METHODS
  LpPLA2 mass was assessed using a dual monoclonal antibody immunoassay. CAC presence was defined as CAC score>0. CAP was defined as focal thickening ≥50% than that of the surrounding vessel wall with a minimal thickness of 1.2 mm on carotid ultrasound.
  
  
  RESULTS
  In 832 NFL players, the median (IQR) age and LpPLA2 levels were 54 (45-63) years and 142 (109-181) ng/mL respectively. LpPLA2 mass was positively correlated with low-density lipoprotein (LDL) cholesterol and high-density lipoprotein cholesterol; negatively correlated with LDL particle concentration and body mass index; and not correlated with high-sensitivity C-reactive protein. CAC was present in 659 (79%) and CAP in 544 (65%) players. In a fully adjusted model, LpPLA2 was not associated with CAC (OR per 1-SD increase, 0.85; 95% CI 0.71-1.02) or CAP (0.90, 0.75-1.08). LpPLA2 was also not associated with CAC burden in those with CAC>0. Results were similar when highest and lowest LpPLA2 tertiles were compared, and also in various subgroups.
  
  
  CONCLUSIONS
  LpPLA2 mass was not associated with coronary or carotid subclinical atherosclerosis in retired NFL players.
authors.affiliation: Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, TC, USA. Electronic address: Yashashwi.pokharel@bcm.edu.
authors.forename: Yashashwi
authors.initials: Y
authors.lastname: Pokharel
authors.affiliation: Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, TC, USA; Michael E. DeBakey VA Medical Center, Houston, TX, USA. Electronic address: vnambi@bcm.edu.
authors.forename: Vijay
authors.initials: V
authors.lastname: Nambi
authors.affiliation: Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA. Electronic address: smart100@jhmi.edu.
authors.forename: Seth S
authors.initials: SS
authors.lastname: Martin
authors.affiliation: Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, TC, USA. Electronic address: ronh@bcm.edu.
authors.forename: Ron C
authors.initials: RC
authors.lastname: Hoogeveen
authors.affiliation: Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA; Center for Prevention and Wellness Research, Baptist Health Medical Group, Miami Beach, FL, USA; Baptist Cardiovascular Institute, Baptist Health South Florida, Miami, FL, USA; Department of Epidemiology, Robert Stempel, USA; Department of Medicine, Herbert Wertheim College of Medicine, Miami, FL, USA. Electronic address: knasir1@jhmi.edu.
authors.forename: Khurram
authors.initials: K
authors.lastname: Nasir
authors.affiliation: Department of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA. Electronic address: Amit.Khera@UTSouthwestern.edu.
authors.forename: Amit
authors.initials: A
authors.lastname: Khera
authors.affiliation: Heart Disease Prevention Program, University of California, Irvine, Irvine, CA, USA. Electronic address: ndwong@uci.edu.
authors.forename: Nathan D
authors.initials: ND
authors.lastname: Wong
authors.affiliation: Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, TC, USA. Electronic address: jones@bcm.edu.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Jones
authors.affiliation: Boone Heart Institute, Denver, CO, USA. Electronic address: jeffboonemd@gmail.com.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Boone
authors.affiliation: Living Heart Foundation, Little Silver, NJ, USA. Electronic address: drrobertslhf@gmail.com.
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Roberts
authors.affiliation: Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, TC, USA. Electronic address: cmb@bcm.edu.
authors.forename: Christie M
authors.initials: CM
authors.lastname: Ballantyne
authors.affiliation: Health Policy, Quality & Informatics Program, Michael E. DeBakey VA Medical Center Health Services Research & Development Center for Innovations, Houston, TX, USA; Michael E. DeBakey VA Medical Center, Houston, TX, USA; Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, TC, USA. Electronic address: virani@bcm.edu.
authors.forename: Salim S
authors.initials: SS
authors.lastname: Virani
mesh_terms: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000097:blood*; D000368:Aged; D000886:Anthropometry; D056352:Athletes; D015415:Biomarkers; D002114:Calcinosis / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology; D002118:Calcium / Q000032:analysis; D002340:Carotid Artery Diseases / Q000097:blood / Q000201:enzymology* / Q000453:epidemiology; D015897:Comorbidity; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000201:enzymology* / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D005538:Football; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000201:enzymology; D008055:Lipids / Q000097:blood; D008297:Male; D008403:Mass Screening; D024821:Metabolic Syndrome / Q000453:epidemiology; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D012179:Retirement; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology; D014481:United States
chemical_list: D015415:Biomarkers; D008055:Lipids; D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase; C526684:PLA2G7 protein, human; D002118:Calcium
keywords: Carotid artery plaque; Coronary artery calcium; Lipoprotein associated phospholipase A(2); National football league; Subclinical atherosclerosis