TY - JOUR
T1 - Association between lipoprotein-associated phospholipase A2 and cardiovascular disease
T2 - A systematic review
AU - Garza, Carolina A.
AU - Montori, Victor M.
AU - McConnell, Joseph P.
AU - Somers, Virend K.
AU - Kullo, Iftikhar J.
AU - Lopez-Jimenez, Francisco
N1 - Funding Information:
Dr Somers is supported by National Institutes of Health grants HL65176, HL61560, HL 70302, and M01-RR00585. Dr Kullo is supported by National Institutes of Health grant HL-813301. Dr Lopez-Jimenez is a recipient of a Clinical Scientist Development Award from the American Heart Association.
PY - 2007/2
Y1 - 2007/2
N2 - OBJECTIVE: To estimate the association between plasma lipoprotein- associated phospholipase A2 (Lp-PLA2) levels and cardiovascular disease (CVD). METHODS: We searched MEDLINE (January 1, 1985, through September 30, 2006), the Cochrane library (from inception through 2006), conference proceedings, and reference sections of obtained articles and contacted experts for unpublished studies. Eligible studies were cohorts with 1 year or more of follow-up or case-control designs that provided risk estimates for CVD according to blood levels of Lp-PLA2 that were unadjusted or adjusted for conventional CVD risk factors. We used randomeffects meta-analysis to estimate the association between Lp-PLA2 and CVD risk and conducted preplanned subgroup analyses to identify risk-subgroup interactions that could explain between-study differences. RESULTS: We found 14 eligible studies (N=20,549 patients) that reported either Lp-PLA2 plasma activity (n=5) or an immunoassay that measured the plasma concentration (n=9). The meta-analytic estimate from the unadjusted odds ratio for the association between elevated Lp-PLA2 levels and CVD risk was 1.51 (95% confidence interval, 1.30-1.75) and from the odds ratio adjusted for conventional CVD risk factors was 1.60 (95% confidence interval, 1.36-1.89). Differences in study methods explained differences in results across studies. CONCLUSIONS: Lipoprotein-associated phospholipase A2 is significantly associated with CVD. The risk estimate appears to be relatively unaffected by adjustment for conventional CVD risk factors. Measurement of Lp-PLA2 may be useful in CVD risk stratification. In addition, Lp-PLA2 may represent a potential therapeutic target for CVD risk reduction.
AB - OBJECTIVE: To estimate the association between plasma lipoprotein- associated phospholipase A2 (Lp-PLA2) levels and cardiovascular disease (CVD). METHODS: We searched MEDLINE (January 1, 1985, through September 30, 2006), the Cochrane library (from inception through 2006), conference proceedings, and reference sections of obtained articles and contacted experts for unpublished studies. Eligible studies were cohorts with 1 year or more of follow-up or case-control designs that provided risk estimates for CVD according to blood levels of Lp-PLA2 that were unadjusted or adjusted for conventional CVD risk factors. We used randomeffects meta-analysis to estimate the association between Lp-PLA2 and CVD risk and conducted preplanned subgroup analyses to identify risk-subgroup interactions that could explain between-study differences. RESULTS: We found 14 eligible studies (N=20,549 patients) that reported either Lp-PLA2 plasma activity (n=5) or an immunoassay that measured the plasma concentration (n=9). The meta-analytic estimate from the unadjusted odds ratio for the association between elevated Lp-PLA2 levels and CVD risk was 1.51 (95% confidence interval, 1.30-1.75) and from the odds ratio adjusted for conventional CVD risk factors was 1.60 (95% confidence interval, 1.36-1.89). Differences in study methods explained differences in results across studies. CONCLUSIONS: Lipoprotein-associated phospholipase A2 is significantly associated with CVD. The risk estimate appears to be relatively unaffected by adjustment for conventional CVD risk factors. Measurement of Lp-PLA2 may be useful in CVD risk stratification. In addition, Lp-PLA2 may represent a potential therapeutic target for CVD risk reduction.
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U2 - 10.4065/82.2.159
DO - 10.4065/82.2.159
M3 - Article
C2 - 17290721
AN - SCOPUS:33846658406
VL - 82
SP - 159
EP - 165
JO - Mayo Clinic Proceedings
JF - Mayo Clinic Proceedings
SN - 0025-6196
IS - 2
ER -