Journal
ARCHIVES OF INTERNAL MEDICINE
Volume 165, Issue 21, Pages 2479-2484Publisher
AMER MEDICAL ASSOC
DOI: 10.1001/archinte.165.21.2479
Keywords
-
Categories
Funding
- NHLBI NIH HHS [N01-HC-55020, N01-HC-55015, N01-HC-55018, N01-HC-55021, N01-HC-55016, N01-HC-55019, N01-HC-55022] Funding Source: Medline
Ask authors/readers for more resources
Background: Measurement of inflammatory markers has been reported to identify individuals at increased risk for ischemic stroke. Lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) is a proinflammatory enzyme secreted by macrophages. We assessed Lp-PLA(2) and C-reactive protein (CRP) levels along with traditional risk factors to examine their relation to ischemic stroke. Methods: A proportional hazards model was used in a prospective case-cohort study of 12 762 apparently healthy middle-aged men and women in the Atherosclerosis Risk in Communities (ARIC) study who were observed for about 6 years. Results: Mean Lp-PLA2 and CRP levels adjusted for sex, race, and age were higher in the 194 stroke cases than the 766 noncases, whereas low-density lipoprotein cholesterol (LDL-C) level was not significantly different. Both Lp-PLA2 and CRP levels were associated with ischemic stroke after adjustment for age, sex, and race: hazard ratios were 2.23 for the highest vs the lowest tertile of Lp-PLA(2) and 2.70 for CRP level higher than 3 vs lower than 1 mg/L. In a model that included smoking, systolic hypertension, lipid levels, and diabetes, Lp-PLA(2) and CRP levels in the highest category were associated with hazard ratios of 1.91 (95% confidence interval, 1.15-3.18; P=.01) and 1.87 (95% confidence interval, 1.13-3. 10; P=.02), respectively. Individuals with high levels of both CRP and Lp-PLA(2) were at the highest risk after adjusting for traditional risk factors compared with individuals with low levels of both, whereas others were at intermediate risk. Conclusion: Levels of Lp-PLA(2) and CRP may be complementary beyond traditional risk factors in identifying middle-aged individuals at increased risk for ischemic stroke.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available