title: Lipoprotein-associated phospholipase A2 and risk of incident cardiovascular disease in a multi-ethnic cohort: The multi ethnic study of atherosclerosis.
abstract: OBJECTIVE
  Prospective studies reporting a positive association of lipoprotein-associated phospholipase A2 (Lp-PLA2) mass and activity with incident cardiovascular disease (CVD) have included primarily white individuals. We evaluated associations of Lp-PLA2 and first-time cardiovascular events in a healthy multi-ethnic cohort characterized by presence or absence of baseline subclinical atherosclerosis.
  
  
  METHODS
  Lp-PLA2 mass and activity were measured at baseline in 5456 participants in the Multi-Ethnic Study of Atherosclerosis. Individuals were characterized for presence of baseline subclinical disease (coronary artery calcium score > 0 or carotid intima-media thickness value > 80th percentile) and followed prospectively for development of CVD events (coronary heart disease, ischemic stroke, and cardiovascular death).
  
  
  RESULTS
  516 incident CVD events occurred over median follow-up of 10.2 years. In adjusted Cox proportional hazards models, each higher standard deviation of both Lp-PLA2 activity and mass was associated with an increased risk of cardiovascular events; hazard ratios (HR; 95% confidence intervals (CI)) 1.12 (1.01-1.26) for Lp-PLA2 activity and 1.10 (1.01-1.21) for mass. Associations did not differ by subclinical disease status (p-value for interaction 0.99 for Lp-PLA2 activity and 0.32 for Lp-PLA2 mass) and there was no confounding by subclinical atherosclerosis measures. Associations of Lp-PLA2 activity but not mass were weaker in Chinese participants but there were relatively few events among Chinese in race-stratified analysis.
  
  
  CONCLUSIONS
  In this multi-ethnic cohort, Lp-PLA2 was positively associated with CVD risk, regardless of the presence of coronary artery calcium or a thickened carotid-intimal media.
authors.affiliation: Division of Cardiovascular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
authors.forename: Parveen K
authors.initials: PK
authors.lastname: Garg
authors.affiliation: Department of Biostatistics, University of Washington, Seattle, WA, USA.
authors.forename: Robyn L
authors.initials: RL
authors.lastname: McClelland
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington, VT, USA.
authors.forename: Nancy S
authors.initials: NS
authors.lastname: Jenny
authors.affiliation: Department of Family & Preventive Medicine, University of California in San Diego, La Jolla, CA, USA.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Criqui
authors.affiliation: Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Philip
authors.initials: P
authors.lastname: Greenland
authors.affiliation: Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Rosenson
authors.affiliation: New York Academy of Medicine, New York, NY, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Siscovick
authors.affiliation: Department of Biostatistics, University of Washington, Seattle, WA, USA.
authors.forename: Neal
authors.initials: N
authors.lastname: Jorgensen
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington, VT, USA; Department of Medicine, University of Vermont College of Medicine, Burlington, VT, USA. Electronic address: mary.cushman@uvm.edu.
authors.forename: Mary
authors.initials: M
authors.lastname: Cushman
mesh_terms: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000097:blood*; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis / Q000201:enzymology* / Q000208:ethnology* / Q000401:mortality; D002340:Carotid Artery Diseases / Q000097:blood / Q000201:enzymology / Q000453:epidemiology; D059168:Carotid Intima-Media Thickness; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000201:enzymology / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D015854:Up-Regulation; D061205:Vascular Calcification / Q000097:blood / Q000201:enzymology / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase; C526684:PLA2G7 protein, human
keywords: Biomarker; Cardiovascular disease; Ethnicity; Inflammation; Lipoprotein-associated phospholipase A(2)