Association of lipoprotein-associated phospholipase A2 and risk of incident atrial fibrillation: Findings from 3 cohorts

Parveen K. Garg, Traci M. Bartz, Faye L. Norby, Neal W. Jorgensen, Robyn L. McClelland, Christie M. Ballantyne, Lin Y. Chen, John S. Gottdiener, Philip Greenland, Ron Hoogeveen, Nancy S. Jenny, Jorge Kizer, Robert S. Rosenson, Elsayed Z. Soliman, Mary Cushman, Alvaro Alonso, Susan R. Heckbert

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Abstract

Background Multiple prospective studies have established an association between inflammation and higher risk of atrial fibrillation (AF), but the association between lipoprotein-associated phospholipase A2 (Lp-PLA2) mass and activity and incident AF has not been extensively evaluated. Methods Using data from 10,794 Atherosclerosis Risk In Communities (ARIC) study participants aged 53-75 years, 5,181 Cardiovascular Health Study (CHS) participants aged 65 to 100 years, and 5,425 Multi-Ethnic Study of Atherosclerosis (MESA) participants aged 45-84 years, we investigated the association between baseline Lp-PLA2 levels and the risk of developing AF. Incident AF was identified in each cohort by follow-up visit electrocardiograms, hospital discharge coding of AF, or Medicare claims data. Results Over a mean of 13.1, 11.5, and 10.0 years of follow-up, 1,439 (13%), 2,084 (40%), and 615 (11%) incident AF events occurred in ARIC, CHS, and MESA, respectively. In adjusted analyses, each SD increment in Lp-PLA2 activity was associated with incident AF in both ARIC (hazard ratio [HR] 1.13, 95% CI 1.06-1.20) and MESA (HR 1.24, 95% CI 1.05-1.46). Each SD increment in Lp-PLA2 mass was also associated with incident AF in MESA (HR 1.25, 95% CI 1.11-1.41). No significant associations were observed among CHS participants. Conclusions Although higher Lp-PLA2 mass and activity were associated with development of AF in ARIC and MESA, this relationship was not observed in CHS, a cohort of older individuals.

Original languageEnglish (US)
Pages (from-to)62-69
Number of pages8
JournalAmerican Heart Journal
Volume197
DOIs
StatePublished - Mar 1 2018

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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Garg, P. K., Bartz, T. M., Norby, F. L., Jorgensen, N. W., McClelland, R. L., Ballantyne, C. M., Chen, L. Y., Gottdiener, J. S., Greenland, P., Hoogeveen, R., Jenny, N. S., Kizer, J., Rosenson, R. S., Soliman, E. Z., Cushman, M., Alonso, A., & Heckbert, S. R. (2018). Association of lipoprotein-associated phospholipase A2 and risk of incident atrial fibrillation: Findings from 3 cohorts. American Heart Journal, 197, 62-69. https://doi.org/10.1016/j.ahj.2017.11.010