Association of Lipoprotein-Associated Phospholipase A(2) with Coronary Artery Disease in African-Americans and Caucasians

Department of Medicine, University of California, Davis, California 95817, USA.
The Journal of Clinical Endocrinology and Metabolism (Impact Factor: 6.21). 03/2010; 95(5):2376-83. DOI: 10.1210/jc.2009-2498
Source: PubMed

ABSTRACT Lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) is bound predominately to low-density lipoprotein and has been implicated as a risk factor for coronary artery disease (CAD).
We investigated the association between Lp-PLA(2) and CAD in a biethnic African-American and Caucasian population.
Lp-PLA(2) mass, activity, and index, an integrated measure of mass and activity, and other cardiovascular risk factors were determined in 224 African-Americans and 336 Caucasians undergoing coronary angiography.
We assessed the distribution of Lp-PLA(2) levels and determined the predictive role of Lp-PLA(2) as a risk factor for CAD.
Levels of Lp-PLA(2) mass and activity were higher among Caucasians compared with African-Americans (293 +/- 75 vs. 232 +/- 76 ng/ml, P < 0.001 for mass and 173 +/- 41 vs. 141 +/- 39 nmol/min/ml, P < 0.001 for activity, respectively). However, Lp-PLA(2) index was similar in the two groups (0.61 +/- 0.17 vs. 0.64 +/- 0.19, P = NS). In both ethnic groups, Lp-PLA(2) activity and index was significantly higher among subjects with CAD. African-American subjects with CAD had significantly higher Lp-PLA(2) index than corresponding Caucasian subjects (0.69 +/- 0.20 vs. 0.63 +/- 0.18, P = 0.028). In multivariate regression analyses, after adjusting for other risk factors, Lp-PLA(2) index was independently (odds ratio 6.7, P = 0.047) associated with CAD in African-Americans but not Caucasians.
Lp-PLA(2) activity and index was associated with presence of CAD among African-Americans and Caucasians undergoing coronary angiography. The findings suggest an independent impact of vascular inflammation among African-Americans as contributory to CAD risk and underscore the importance of Lp-PLA(2) as a cardiovascular risk factor.

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    • "Lp-PLA2 hydrolyzes platelet-activating factor (PAF) and oxidizes phospholipids with a modified short fatty acyl chain esterified at the Sn-2 position [2]. Many studies have indicated that Lp-PLA2 is an independent predictor for cardiovascular disease (CAD), with elevated Lp-PLA2 activity associated with an increased risk for CAD [3-5]. Additionally, Lp-PLA2 levels have been implicated in atherosclerotic plaque formation [6], inflammatory bowel disease [7], acute respiratory distress syndrome [8] and severe anaphylaxis [9]. "
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