Abstract 4033: Lipoprotein-Associated Phospholipase A2 Activity and Risk of Heart Failure. The Rotterdam Study.
This study was supported by the Netherlands HeartFoundation (grant 2002B190)
Background - Evidence is accumulating that inflammation plays a role in the pathophysiology of heart failure. Lipoprotein-associated phospholipase A2 (Lp-PLA2) has pro-inflammatory properties and is independently associated with cardiovascular events. We assessed the hypothesis that Lp-PLA2 activity is associated with development of heart failure. This hypothesis has not been investigated previously.
Methods and results - Lp-PLA2 activity was determined in a random sample of 1820 participants from the Rotterdam Study, a population-based cohort study among men and women aged 55 years and over. We excluded participants with heart failure or coronary heart disease at baseline. We accounted for incident coronary heart disease during follow-up by censoring participants in which coronary heart disease occurred prior to incident heart failure. During a mean follow up of 6.7 years, 91 heart failure cases occurred. We used a Cox proportional hazards model to compute hazard ratios of developing heart failure adjusted for age, sex, non-HDL cholesterol, HDL cholesterol, body mass index, systolic blood pressure, diastolic blood pressure, hypertension, diabetes mellitus, smoking and C-reactive protein. Hazard ratios for the second, third and fourth quartiles of Lp-PLA2 activity were 1.10 (95% confidence interval, 0.57 to 2.14), 1.40 (0.70 to 2.81) and 2.34 (1.20 to 4.59), respectively, P for trend = 0.007, using the lowest quartile as the reference category.
Conclusions - In conclusion, this study suggests that Lp-PLA2 activity is independently associated with incident heart failure, and provides further evidence that inflammation is involved in the etiology of heart failure. Future studies are warranted to further elucidate the possible pathofysiological role of Lp-PLA2 in the development of heart failure.