Journal article
Clinical utility of lipoprotein-associated phospholipase A₂ for cardiovascular disease prediction in a multiethnic cohort of women
Clinical chemistry (Baltimore, Md.), Vol.58(9), pp.1352-1363
09/2012
DOI: 10.1373/clinchem.2012.188870
PMCID: PMC3621122
PMID: 22859728
Abstract
Findings regarding the association of lipoprotein-associated phospholipase A₂ (Lp-PLA2) activity and mass with incident cardiovascular disease (CVD) have been inconsistent, and their role in risk prediction is uncertain.
A case-cohort sample from the Women's Health Initiative Observational Study (WHI-OS) comprised 1821 CVD cases and a reference subcohort of 1992 women. We used Cox regression models with inverse sampling weights to assess the association of Lp-PLA2 mass and activity with CVD (myocardial infarction, stroke, and CVD mortality).
Subcohort means were 184.3 mmol/min/mL for Lp-PLA2 activity and 499.2 μg/L for Lp-PLA2 mass, with 99% having mass above 200 μg/L, the clinically recommended cut point. Both activity and mass were positively associated with incident CVD in age- and race/ethnicity-adjusted analyses. Following adjustment according to CVD risk factors, the association with activity became null (hazard ratio = 1.02 for top vs bottom quartile, 95% CI = 0.79-1.33, P for trend = 0.65), but the association with mass remained (hazard ratio = 1.84, 95% CI = 1.45-2.34, P for trend < 0.0001). In contrast to blood pressure, HDL, and hsCRP, reclassification statistics for Lp-PLA2 mass did not suggest improvement for overall CVD after full adjustment.
In the WHI-OS Lp-PLA2 mass, but not activity, was independently associated with CVD. However, model fit did not significantly improve with Lp-PLA2 mass, and assay calibration remains a clinical concern.
Details
- Title: Subtitle
- Clinical utility of lipoprotein-associated phospholipase A₂ for cardiovascular disease prediction in a multiethnic cohort of women
- Creators
- Nancy R Cook - Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA. ncook@rics.bwh.harvard.eduNina P PaynterJoann E MansonLisa W MartinJennifer G RobinsonSylvia Wassertheil-SmollerPaul M Ridker
- Resource Type
- Journal article
- Publication Details
- Clinical chemistry (Baltimore, Md.), Vol.58(9), pp.1352-1363
- Publisher
- England
- DOI
- 10.1373/clinchem.2012.188870
- PMID
- 22859728
- PMCID
- PMC3621122
- ISSN
- 1530-8561
- eISSN
- 1530-8561
- Grant note
- N01 WH044221 / WHI NIH HHS N01WH42123 / WHI NIH HHS N01WH32111 / WHI NIH HHS N01WH42132 / WHI NIH HHS N01WH42118 / WHI NIH HHS N01WH42114 / WHI NIH HHS N01WH42110 / WHI NIH HHS N01WH32106 / WHI NIH HHS N01WH32119 / WHI NIH HHS HHSN268200960011C / NHLBI NIH HHS N01WH32115 / WHI NIH HHS N01WH32102 / WHI NIH HHS N01WH24152 / WHI NIH HHS N01WH32101 / WHI NIH HHS N01WH42131 / WHI NIH HHS N01WH42108 / WHI NIH HHS N01WH42126 / WHI NIH HHS N01 WH042107 / WHI NIH HHS N01WH42113 / WHI NIH HHS N01WH42117 / WHI NIH HHS HHSN268200960011C / PHS HHS N01WH44221 / WHI NIH HHS N01WH32109 / WHI NIH HHS N01WH32105 / WHI NIH HHS N01WH32118 / WHI NIH HHS N01WH42122 / WHI NIH HHS N01WH42107 / WHI NIH HHS N01WH42130 / WHI NIH HHS N01WH42125 / WHI NIH HHS N01WH42112 / WHI NIH HHS N01WH42129 / WHI NIH HHS N01WH32122 / WHI NIH HHS N01WH42116 / WHI NIH HHS N01WH32108 / WHI NIH HHS N01WH32113 / WHI NIH HHS N01 WH042129 / WHI NIH HHS N01WH32100 / WHI NIH HHS N01WH42121 / WHI NIH HHS N01WH42115 / WHI NIH HHS N01WH42124 / WHI NIH HHS N01WH32112 / WHI NIH HHS N01WH42119 / WHI NIH HHS N01 WH032100 / WHI NIH HHS N01WH22110 / WHI NIH HHS N01 WH32115 / WHI NIH HHS N01WH42111 / WHI NIH HHS N01WH42120 / WHI NIH HHS N01WH42109 / WHI NIH HHS
- Language
- English
- Date published
- 09/2012
- Academic Unit
- Epidemiology; Internal Medicine
- Record Identifier
- 9983995005902771
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