Lipoprotein-Associated Phospholipase A 2 as an Independent Predictor of Coronary Heart Disease

作者：Chris J. Packard, Denis St J O’Reilly, MURIEL J. CASLAKE, Alex D. McMahon, Ian Ford, Josephine Cooney, Colin H. Macphee, Keith E. Suckling, Mala Krishna, Francis E. Wilkinson, Ann Rumley, Gillian Docherty, John D. Burczak, Gordon D O Lowe · 发表于：New England Journal of Medicine · 年份：2000 · DOI：10.1056/nejm200010193431603 · 被引用次数：817 · 研究领域：Blood properties and coagulation、Protease and Inhibitor Mechanisms、Adipokines, Inflammation, and Metabolic Diseases

BACKGROUND: Chronic inflammation is believed to increase the risk of coronary events by making atherosclerotic plaques in coronary vessels prone to rupture. We examined blood constituents potentially affected by inflammation as predictors of risk in men with hypercholesterolemia who were enrolled in the West of Scotland Coronary Prevention Study, a trial that evaluated the value of pravastatin in the prevention of coronary events. METHODS: A total of 580 men who had had a coronary event (nonfatal myocardial infarction, death from coronary heart disease, or a revascularization procedure) were each matched for age and smoking status with 2 control subjects (total, 1160) from the same cohort who had not had a coronary event. Lipoprotein-associated phospholipase A2, C-reactive protein, and fibrinogen levels, and the white-cell count were measured at base line, along with other traditional risk factors. The association of these variables with the risk of coronary events was tested in regression models and by dividing the range of values according to quintiles. RESULTS: Levels of C-reactive protein, the white-cell count, and fibrinogen levels were strong predictors of the risk of coronary events; the risk in the highest quintile of the study cohort for each variable was approximately twice that in the lowest quintile. However, the association of these variables with risk was markedly attenuated when age, systolic blood pressure, and lipoprotein levels were included in multivariate ...