Platelet-activating factor acetylhydrolase activity indicates angiographic coronary artery disease independently of systemic inflammation and other risk factors: the Ludwigshafen Risk and Cardiovascular Health Study.

Abstract

BACKGROUND:

Platelet-activating factor acetylhydrolase (PAF-AH), also denoted as lipoprotein-associated phospholipase A2, is a lipoprotein-bound enzyme that is possibly involved in inflammation and atherosclerosis. This study investigates the relationship of PAF-AH activity to angiographic coronary artery disease (CAD), the use of cardiovascular drugs, and other established risk factors.

METHODS AND RESULTS:

PAF-AH activity, lipoproteins, sensitive C-reactive protein (sCRP), fibrinogen, serum amyloid A, and white blood cell count were determined in 2454 subjects with angiographically confirmed CAD and in 694 control subjects. PAF-AH activity was highly correlated with LDL cholesterol (r=0.517), apolipoprotein B (r=0.644), and non-HDL cholesterol (r=0.648) but not with sCRP or fibrinogen. PAF-AH activity was lower in women than in men and was affected by the intake of lipid-lowering drugs (-12%; P<0.001), aspirin (-6%; P<0.001), beta-blockers (-6%; P<0.001), and digitalis (+7%; P<0.001). Unlike sCRP, fibrinogen, and serum amyloid A, PAF-AH activity was not elevated in unstable angina, non-ST-elevation myocardial infarction, or ST-elevation myocardial infarction. When nonusers of lipid-lowering drugs were examined, PAF-AH activity was associated with the severity of CAD and the number of coronary vessels with significant stenoses. In individuals not taking lipid-lowering drugs and after adjustment for use of aspirin, beta-blocker, and digitalis, the odds ratio for CAD associated with increasing PAF-AH activity was 1.39 (95% CI 1.26 to 1.54, P<0.001), a finding that was robust against further adjustments.

CONCLUSIONS:

PAF-AH activity is not an indicator of the systemic inflammation that accompanies acute coronary syndromes. PAF-AH activity is affected by a number of cardiovascular drugs; however, after such medication use was accounted for, PAF-AH activity was associated with angiographic CAD, complementary to sCRP and independently of established risk factors such as LDL cholesterol.

• Authors: Karl Winkler, Bernhard R Winkelmann, Hubert Scharnagl, Michael M Hoffmann, Andrea Busse Grawitz, Markus Nauck, Bernhard O Böhm, Winfried März
• Journal: Circulation (Circulation) Vol. 111 Issue 8 Pg. 980-7 (Mar 01 2005) ISSN: 1524-4539 [Electronic] United States
• PMID: 15710755 (Publication Type: Journal Article)

Chemical References

• Biomarkers
• Hypolipidemic Agents
• Lipoproteins
• Phospholipases A2
• 1-Alkyl-2-acetylglycerophosphocholine Esterase

Topics

• 1-Alkyl-2-acetylglycerophosphocholine Esterase (blood)
• Aged
• Angina, Unstable (blood, enzymology)
• Biomarkers (blood)
• Coronary Artery Disease (blood, diagnostic imaging, enzymology)
• Female
• Humans
• Hypolipidemic Agents (therapeutic use)
• Inflammation (blood, enzymology)
• Lipoproteins (blood)
• Male
• Middle Aged
• Myocardial Infarction (blood, enzymology)
• Phospholipases A2
• Radiography
• Risk Factors