Abstract | BACKGROUND: 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 models. Levels of lipoprotein-associated phospholipase A2 ( platelet-activating factor acetylhydrolase), the expression of which is regulated by mediators of inflammation, had a strong, positive association with risk that was not confounded by other factors. It was associated with almost a doubling of the risk in the highest quintile as compared with the lowest quintile. CONCLUSIONS:
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Authors | C J Packard, D S O'Reilly, M J Caslake, A D McMahon, I Ford, J Cooney, C H Macphee, K E Suckling, M Krishna, F E Wilkinson, A Rumley, G D Lowe |
Journal | The New England journal of medicine
(N Engl J Med)
Vol. 343
Issue 16
Pg. 1148-55
(Oct 19 2000)
ISSN: 0028-4793 [Print] United States |
PMID | 11036120
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Anticholesteremic Agents
- Biomarkers
- Triglycerides
- Fibrinogen
- C-Reactive Protein
- Cholesterol
- Phospholipases A
- Phospholipases A2
- 1-Alkyl-2-acetylglycerophosphocholine Esterase
- Pravastatin
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Topics |
- 1-Alkyl-2-acetylglycerophosphocholine Esterase
- Anticholesteremic Agents
(therapeutic use)
- Biomarkers
(blood)
- C-Reactive Protein
(analysis)
- Case-Control Studies
- Cholesterol
(blood)
- Coronary Disease
(etiology, mortality)
- Fibrinogen
(analysis)
- Humans
- Hypercholesterolemia
(blood, complications, drug therapy)
- Inflammation
(blood, complications, diagnosis)
- Leukocyte Count
- Logistic Models
- Male
- Middle Aged
- Myocardial Infarction
(etiology)
- Phospholipases A
(blood)
- Phospholipases A2
- Pravastatin
(therapeutic use)
- Risk Factors
- Triglycerides
(blood)
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