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Distribution and Correlates of Lipoprotein‐Associated Phospholipase A 2 in an Elderly Cohort: The Cardiovascular Health Study
Author(s) -
Furberg Curt D.,
Nelson Jeanenne J.,
Solomon Cam,
Cushman Mary,
Jenny Nancy Swords,
Psaty Bruce M.
Publication year - 2008
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2008.01667.x
Subject(s) - medicine , lipoprotein associated phospholipase a2 , cohort , myocardial infarction , population , lipoprotein(a) , ejection fraction , kidney disease , lipoprotein , cohort study , endocrinology , cholesterol , cardiology , heart failure , environmental health
OBJECTIVES: To determine whether high levels of lipoprotein‐associated phospholipase A 2 (Lp‐PLA 2 ) are associated with prevalent cardiovascular disease (CVD) and to evaluate factors most influencing Lp‐PLA 2 levels in a community‐based cohort of older adults. DESIGN: Cross‐sectional. SETTING: The Cardiovascular Health Study (CHS), a population‐based cohort study of men and women aged 65 and older. PARTICIPANTS: Five thousand five hundred thirty‐one CHS participants. MEASUREMENTS: Levels of Lp‐PLA 2 activity were determined using stored blood samples from the baseline examination. RESULTS: Mean Lp‐PLA 2 was higher in participants with electrocardiographically determined ventricular conduction defect and major Q‐wave abnormality and was positively correlated with left ventricular (LV) mass. It was high in those with echocardiographically determined abnormal LV ejection fraction, which persisted after adjustment. Mean Lp‐PLA 2 was also higher in participants with mild renal insufficiency and kidney disease. After multivariable adjustment, there was a modest but significant 27% greater risk of prevalent CHF per standard deviation increment of Lp‐PLA 2 and a modest but significant 12% greater risk of prevalent myocardial infarction. Lp‐PLA 2 was weakly but mainly most strongly correlated with cholesterol and lipoproteins, but those correlations were not especially strong. Lp‐PLA 2 was weakly positively correlated with soluble intercellular adhesion molecule‐1 but not interleukin‐6. In total, all factors considered could explain only 29% of Lp‐PLA 2 activity. CONCLUSION: Novel findings in the study are the associations, in those aged 65 and older, between Lp‐PLA 2 activity and LV dysfunction, CHF, and renal disease. CVD risk factors only minimally explain levels of Lp‐PLA 2 .