• Muriel J Caslake, Chris J Packard, Michele Robertson, Josephine Cooney, Jeanenne J Nelson, Ian Ford, Allan Gaw, J Wouter Jukema, Peter W Macfarlane, David J Stott, James Shepherd, and PROSPER Study Group.
• Division of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G11 6NT, UK. muriel.caslake@clinmed.gla.ac.uk
• Atherosclerosis. 2010 May 1; 210 (1): 28-34.

ObjectiveLipoprotein-associated phospholipase A(2) (Lp-PLA(2)) is an inflammatory biomarker that circulates mainly bound to LDL. We evaluated the association of Lp-PLA(2) with vascular events in the elderly where the importance of LDL is diminished as a risk factor for coronary disease.MethodsMass and activity of Lp-PLA(2) were related to risk over 3.2 years for vascular events (definite or suspected death from CHD, non-fatal MI, fatal or non-fatal stroke) in the 2804 men and 3000 women age 70-82 years in the Prospective Study of Pravastatin in the Elderly (PROSPER).ResultsLp-PLA(2) showed a moderate, positive association with risk of a vascular event with hazard ratios of 1.25 (confidence interval (CI) 1.02-1.54) for mass and 1.39 (CI 1.14-1.70) for activity for top versus bottom quartile. Risk associations were attenuated when classical risk factors, lipids and inflammatory markers - C-reactive protein and white cell count - were included in the models. Lp-PLA(2) was unrelated to stroke risk. Inclusion of all three inflammatory markers in multivariate models negated the association of HDL cholesterol with risk (hazard ratio 0.98; CI 0.88-1.10) and increased prediction of coronary events; the C statistic rose from 63.2% to 64.4% (P<0.001).ConclusionIn elderly people Lp-PLA(2), alongside other inflammatory indices, is a potential biomarker for vascular events, particularly CHD.Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

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