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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2005;25:216.)
© 2005 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Association of Lipoprotein-Associated Phospholipase A₂ Mass and Activity With Calcified Coronary Plaque in Young Adults

The CARDIA Study

Carlos Iribarren; Myron D. Gross; Jeanne A. Darbinian; David R. Jacobs, Jr; Stephen Sidney; Catherine M. Loria

From the Division of Research (C.I., J.A.D., S.S.), Kaiser Permanente, Oakland, Calif; the Department of Laboratory Medicine and Pathology (M.D.G.), School of Medicine, University of Minnesota, Minneapolis; the Division of Epidemiology (M.D.G., D.R.J.), School of Public Health, University of Minnesota, Minneapolis; the Institute for Nutrition Research (D.R.J.), University of Oslo, Oslo, Norway; and National Institutes of Health/National Heart, Lung, and Blood Institute/Division of Epidemiology and Clinical Applications (C.M.L.), Epidemiology and Biometry Program, Bethesda, Md.

Correspondence to Carlos Iribarren, MD, MPH, PhD, Division of Research, Kaiser Permanente, 2000 Broadway, Oakland, CA. E-mail cgi{at}dor.kaiser.org

Objective— To examine the association of lipoprotein-associated phospholipase A₂ (Lp-PLA₂) mass and activity with calcified coronary plaque in young adults.

Methods and Results— Nested case-control study among CARDIA participants at the year 15 examination (2000 to 2001, 33 to 45 years old). Cases (n=266) were those with and controls (n=266) those without evidence of calcified coronary plaque by computed tomography matched 1:1 on sex and race. Lp-PLA₂ mass and activity were significantly higher in cases (296±101 ng/mL and 36.4±12.3 nmol/mL per minute) than in controls (267±80 ng/mL and 32.9±11.8 nmol/mL per minute). In age-adjusted conditional logistic regression, the odds ratio (OR) of calcified coronary plaque per 1 standard deviation (SD) increment was 1.40 (95% CI, 1.17 to 1.67) and 1.39 (95% CI, 1.14 to 1.70) for Lp-PLA₂ mass and activity, respectively. After adjusting for multiple covariates including low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, and C-reactive protein, a statistically significant association remained for Lp-PLA₂ mass (OR, 1.28; 95% CI, 1.03 to 1.60) but not for activity (OR, 1.09; 95% CI, 0.84 to 1.42). No evidence was found for interaction between Lp-PLA₂ mass or activity with LDL-C as predictors of calcified coronary plaque.

Conclusion— An independent association of Lp-PLA₂ mass with calcified coronary plaque existed in young adults. Therefore, Lp-PLA₂ mass may be a useful marker of subclinical cardiovascular risk.

This nested case-control study among CARDIA participants at the year 15 examination (2000 to 01, 33 to 45 years old) demonstrates an independent association of Lp-PLA₂ mass (but not its activity) with presence and amount of calcified coronary plaque. Therefore, Lp-PLA₂ mass may be a useful marker of sub-clinical cardiovascular risk.

Key Words: phospholipases • coronary calcification • young adults • atherosclerosis • risk factors

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