Lipoprotein-associated phospholipase A2, high-sensitivity C-reactive protein, and risk for incident coronary heart...

Area of Science:

• Cardiovascular Medicine
• Biomarkers
• Epidemiology

Background:

• C-reactive protein (CRP) is recommended for identifying coronary heart disease (CHD) risk in patients with low LDL cholesterol.
• Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a proinflammatory enzyme linked to LDL.

Purpose of the Study:

• To examine the relationship between Lp-PLA2, CRP, traditional risk factors, and CHD risk.
• To assess the combined utility of Lp-PLA2 and CRP in identifying high-risk individuals, particularly those with low LDL cholesterol.

Main Methods:

• Prospective case cohort study of 12,819 apparently healthy middle-aged men and women.
• Analysis using a proportional hazards model, stratified by LDL cholesterol levels.
• Assessment of Lp-PLA2, CRP, and traditional risk factors over approximately 6 years.

Main Results:

• Lp-PLA2 and CRP levels were higher in CHD cases compared to noncases.
• Both Lp-PLA2 and CRP were associated with incident CHD after adjustments.
• For individuals with LDL cholesterol below 130 mg/dL, Lp-PLA2 and CRP were independently associated with CHD risk.
• The association of Lp-PLA2 with CHD was attenuated when adjusted for LDL-C in the overall cohort.

Conclusions:

• Lp-PLA2 and CRP may serve as complementary biomarkers.
• These markers can help identify individuals with low LDL cholesterol who are at high risk for CHD.