03185nas a2200469 4500008004100000022001400041245013300055210006900188260001300257300001100270490000600281520182900287653005102116653000902167653001502176653002302191653001102214653001502225653001802240653001102258653001402269653002702283653001802310653002602328653000902354653002802363653003202391653002402423653002002447653001702467653001702484653001802501100001902519700001702538700002502555700001902580700002402599700002002623700001802643700001802661856003602679 2009 eng d a1941-329700aLipoprotein-associated phospholipase A(2) and risk of congestive heart failure in older adults: the Cardiovascular Health Study.0 aLipoproteinassociated phospholipase A2 and risk of congestive he c2009 Sep a429-360 v23 a
BACKGROUND: Inflammation may be a causative factor in congestive heart failure (CHF). Lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) is an inflammation marker associated with vascular risk. One previous study showed an association of Lp-PLA(2) activity with CHF risk, but there were only 94 CHF cases and Lp-PLA(2) antigen, which is available clinically in the United States, was not measured.
METHODS AND RESULTS: We measured baseline Lp-PLA(2) antigen and activity in 3991 men and women without baseline CHF or cardiovascular disease who were participating in the Cardiovascular Health Study, a prospective observational study of adults 65 years or older. Cox proportional hazards models adjusted for age, sex, clinic site, race, low-density and high-density lipoprotein cholesterol, body mass index, systolic and diastolic blood pressure, hypertension, smoking status, pack-years, and diabetes were used to calculate hazard ratios and 95% CIs for incident CHF. Further models adjusted for coronary disease events during follow-up and C-reactive protein. Eight hundred twenty-nine participants developed CHF during 12.1 years. Adjusted hazard ratios for CHF with Lp-PLA(2) in the fourth compared with the first quartile were 1.44 (95% CI, 1.16 to 1.79) for Lp-PLA(2) antigen and 1.06 (95% CI, 0.84 to 1.32) for activity. Adjustment for incident coronary disease attenuated the hazard ratio for Lp-PLA(2) antigen to 1.26 (95% CI, 1.02 to 1.57), adjustment for C-reactive protein had minimal impact.
CONCLUSIONS: Lp-PLA(2) antigen was associated with risk of future CHF in older people, independent of CHF and coronary risk factors, and partly mediated by coronary disease events. Further clinical and basic research is needed to better understand the role of Lp-PLA(2) in CHF.
10a1-Alkyl-2-acetylglycerophosphocholine Esterase10aAged10aBiomarkers10aC-Reactive Protein10aFemale10aFibrinogen10aHeart Failure10aHumans10aIncidence10aInflammation Mediators10aInterleukin-610aKaplan-Meier Estimate10aMale10aPopulation Surveillance10aProportional Hazards Models10aProspective Studies10aRisk Assessment10aRisk Factors10aTime Factors10aUnited States1 aSuzuki, Takeki1 aSolomon, Cam1 aJenny, Nancy, Swords1 aTracy, Russell1 aNelson, Jeanenne, J1 aPsaty, Bruce, M1 aFurberg, Curt1 aCushman, Mary uhttps://chs-nhlbi.org/node/1135