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. 2010 May;95(5):2376-83.
doi: 10.1210/jc.2009-2498. Epub 2010 Mar 1.

Association of lipoprotein-associated phospholipase A2 with coronary artery disease in African-Americans and Caucasians

Erdembileg Anuurad  1 , Zeynep Ozturk, Byambaa Enkhmaa, Thomas A Pearson, Lars Berglund
Affiliations

Association of lipoprotein-associated phospholipase A2 with coronary artery disease in African-Americans and Caucasians

Erdembileg Anuurad et al. J Clin Endocrinol Metab. 2010 May.

Abstract

Context: 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).

Objective: We investigated the association between Lp-PLA(2) and CAD in a biethnic African-American and Caucasian population.

Design: 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.

Main outcome measures: We assessed the distribution of Lp-PLA(2) levels and determined the predictive role of Lp-PLA(2) as a risk factor for CAD.

Results: 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.

Conclusions: 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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Figures

Figure 1
Figure 1
Distribution of Lp-PLA2 mass (A), activity (B), and index (C) across ethnicity. Results were based on 336 Caucasians and 224 African-Americans. NS, Not significant. Data represent median and interquartile range. ○, Outliers. P values were calculated using Student’s t test analysis, and values for Lp-PLA2 mass and activity were logarithmically transformed before analysis. Nontransformed values are shown in the graphs.
Figure 2
Figure 2
Lp-PLA2 mass (A), activity (B), and index (C) levels in subjects with and without CAD across ethnicity. Data are means ± sd. *, P < 0.05. P values were calculated using Student’s t test analysis, and values for Lp-PLA2 mass and activity were logarithmically transformed before analysis. Nontransformed values are shown in the graphs. Results were based on n = 140 CAD(−), n = 187 CAD(+) Caucasians, and n = 119 CAD(−), n = 99 CAD(+) African-Americans.
Figure 3
Figure 3
Cardiovascular composite score across Lp-PLA2 mass (A), activity (B), and index (C) tertiles in Caucasian and African-American subjects. Data are means ± sd. *, P < 0.05. P values were calculated using one-way ANOVA test, and post hoc analyses were performed by Tukey’ honestly significant difference test. Values for Lp-PLA2 mass and activity were logarithmically transformed before analysis. Nontransformed values are shown in the graphs.
Figure 4
Figure 4
Cumulative distribution of Lp-PLA2 mass (A), activity (B), and index (C) in Caucasians and African-Americans with and without CAD.
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