Lipoprotein-Associated Phospholipase A2 Activity Improves Risk Discrimination of Incident Coronary Heart Disease Among Women
Hatoum, Ida J.
Cook, Nancy R.
Nelson, Jeanenne J.
Rexrode, Kathryn M.
Rimm, Eric Bruce::0ab2926c8242f35e5a982e3cf59f4987::600
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CitationHatoum, Ida J., Nancy R. Cook, Jeanenne J. Nelson, Kathryn M. Rexrode, and Eric B. Rimm. 2011. “Lipoprotein-Associated Phospholipase A2 Activity Improves Risk Discrimination of Incident Coronary Heart Disease among Women.” American Heart Journal 161 (3): 516–22. https://doi.org/10.1016/j.ahj.2010.11.007.
AbstractBackground This study sought to determine the relation between and discriminative capability of lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) and coronary heart disease (CHD) in a large population of disease-free women.Methods Among participants of the Nurses' Health Study who provided a blood sample, there were 421 cases of incident myocardial infarction during 14 years of follow-up. Controls were matched to cases 2:1 using risk set sampling based on age, smoking, and blood draw date.Results After conditioning on the matching factors, Lp-PLA(2) activity was significantly associated with myocardial infarction (relative risk [RR] 2.86 for extreme quartiles, 95% CI 1.98-4.12). Upon additional adjustment for lipid, inflammatory, and clinical risk factors, the RR remained statistically significant (RR 1.75, 95% CI 1.09-2.84). The discriminative capability of Lp-PLA(2) was assessed by comparing the area below the receiver operating characteristic curves for models with and without Lp-PLA(2) and by calculating the net reclassification improvement index. The addition of Lp-PLA(2) activity to a multivariable-adjusted model increased the receiver operating characteristic curves from 0.720 to 0.733 and significantly improved the net reclassification improvement index (P = .004).Conclusions Levels of Lp-PLA(2) activity were significantly associated with incident CHD among women. In addition, Lp-PLA(2) activity added significantly to CHD risk discrimination. (Am Heart J 2011;161:516-22.)
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