title: Lipoprotein-associated phospholipase A2 and carotid intima-media thickness in individuals classified as low-risk according to Framingham.
abstract: BACKGROUND
  The Framingham risk score (FRS) has long been used as a global tool to estimate coronary heart disease (CHD) risk, but data has shown that subclinical CHD may exist in those classified as low risk by FRS, and as a result, there is potential for misclassification. Lipoprotein-associated phospholipase A2 (Lp-PLA2) and carotid intima-media thickness (CIMT) are two emerging risk markers that are predictive of future CHD events.
  
  
  OBJECTIVE
  To examine Lp-PLA2 and CIMT values in low risk individuals, and to explore the relationship between Lp-PLA2 and CIMT.
  
  
  METHODS
  A total of 229 men and women (age =53±7 years) underwent body composition analysis, objective physical activity measurement, fasting blood draw to determine standard lipid values and Lp-PLA2 mass, and CIMT measurement through ultrasound.
  
  
  RESULTS
  For all subjects, mean CIMT was 0.61±0.1 mm, mean Lp-PLA2 mass was 197±45 ng/dL. A total of 19.5% and 34.6% of women and 4.6% and 73.8% of men were considered at elevated risk for CHD by CIMT (>75(th) percentile for age) and Lp-PLA2 mass (>200 ng/dL) standards, respectively. Both CIMT and Lp-PLA2 mass were significant independent predictors of each other, whereas traditional risk markers (lipids, glucose) were not.
  
  
  CONCLUSIONS
  Results suggest that in those classified as low risk by FRS, evidence of increased CHD risk may exist through the use of newer risk markers like CIMT and Lp-PLA2. These emerging markers may aid in the earlier detection and intervention of subclinical CHD.
authors.affiliation: 1 Human Performance Laboratory, Department of Kinesiology, James Madison University, Harrisonburg, VA 22807, USA ; 2 Clinical Exercise Physiology Program, Human Performance Laboratory, Ball State University, Muncie, IN, USA.
authors.forename: Trent A
authors.initials: TA
authors.lastname: Hargens
authors.affiliation: 1 Human Performance Laboratory, Department of Kinesiology, James Madison University, Harrisonburg, VA 22807, USA ; 2 Clinical Exercise Physiology Program, Human Performance Laboratory, Ball State University, Muncie, IN, USA.
authors.forename: Philip G
authors.initials: PG
authors.lastname: Rhodes
authors.affiliation: 1 Human Performance Laboratory, Department of Kinesiology, James Madison University, Harrisonburg, VA 22807, USA ; 2 Clinical Exercise Physiology Program, Human Performance Laboratory, Ball State University, Muncie, IN, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: VanReenen
authors.affiliation: 1 Human Performance Laboratory, Department of Kinesiology, James Madison University, Harrisonburg, VA 22807, USA ; 2 Clinical Exercise Physiology Program, Human Performance Laboratory, Ball State University, Muncie, IN, USA.
authors.forename: Leonard A
authors.initials: LA
authors.lastname: Kaminsky
keywords: Framingham risk score (FRS); carotid intima-media thickness (CIMT); coronary heart disease (CHD); lipoprotein-associated phospholipase A2 (Lp-PLA2)