Serum levels of type II secretory phospholipase A2 and the risk of future coronary artery disease in apparently healthy men and women - The EPIC-Norfolk Prospective Population study

Objectives - To study the prospective relationship between serum levels of type II secretory phospholipase A2 (sPLA2) and the risk of future coronary artery disease ( CAD) in apparently healthy men and women. Methods and Results - We conducted a prospective nested case-control study among apparently healthy men and women aged 45 to 79 years. Cases ( n = 1105) were people in whom fatal or nonfatal CAD developed during follow-up. Controls ( n = 2209) were matched by age, sex, and enrollment time. sPLA2 levels were significantly higher in cases than controls ( 9.5 ng/mL; interquartile range [IQR], 6.4 to 14.8 versus 8.3 ng/mL; IQR, 5.8 to 12.6; P < 0.0001). sPLA2 plasma levels significantly correlated with age, body mass index, systolic blood pressure, high-density lipoprotein (HDL) cholesterol levels, and C-reactive protein ( CRP) levels. Taking into account matching for sex and age and adjusting for body mass index, smoking, diabetes, systolic blood pressure, low-density lipoprotein cholesterol, HDL cholesterol, and CRP levels, the risk of future CAD was 1.34 ( 1.02 to 1.71; P = 0.02) for people in the highest sPLA2 quartile, compared with those in the lowest ( P for linearity = 0.03). Conclusion - Elevated levels of sPLA2 were associated with an increased risk of future CAD in apparently healthy individuals. The magnitude of the association was similar to that observed between CRP and CAD risk, and both associations were independent.