Abstract 11409: Lipoprotein-Associated Phospholipase A2 is Associated with Incident Peripheral Arterial Disease: The Cardiovascular Health Study
Introduction: Lipoprotein-associated Phospholipase A2 (Lp-PLA2) is an enzyme specific for vascular inflammation. Although prior studies have reported a relationship between elevated Lp-PLA2 levels and both incident cardiovascular and cerebrovascular disease, the association of Lp-PLA2 levels with incident peripheral arterial disease (PAD) has not been studied. We investigated the association between baseline Lp-PLA2 levels and the risk of developing clinical PAD.
Methods: Participants were part of the Cardiovascular Health Study, a population-based cohort of 5,888 adults aged 65 years or older. Lp-PLA2 mass and activity were measured at baseline. Participants with missing baseline ABI (n=140) or Lp-PLA2 (n=257) data were excluded. Those with clinical PAD (n=95), an ABI<0.9 (n=771), or an ABI>1.4 (n=176) at baseline were also excluded. Over a median follow-up of 12.5 years, 4458 individuals were followed for the development of clinical PAD, defined as leg artery revascularization or diagnosed claudication.
Results: 177 participants developed symptomatic PAD during follow-up. In adjusted Cox proportional hazards models, higher baseline Lp-PLA2 mass was associated with a significantly higher risk of developing clinical PAD (Table). Compared to participants in the lowest baseline quartile of Lp-PLA2 mass, those in the highest baseline quartile had a significantly higher risk of developing clinical PAD (Table). Risk was not attenuated after additional adjustment for C-reactive protein. No associations were observed for Lp-PLA2 activity and risk of developing clinical PAD
Conclusions: Higher Lp-PLA2 mass, but not activity, is associated with development of incident clinical PAD. Future studies are needed to determine whether pharmacologic inhibition of Lp-PLA2 reduces the incidence of clinical PAD.
- © 2011 by American Heart Association, Inc.