Association of lipoprotein-associated phospholipase A(2) and risk of incident atrial fibrillation: Findings from 3 cohorts

• Authors: Parveen K Garg, University of Southern California; Traci M Bartz, University of Washington; Faye L Norby, University of Minnesota; Neal W Jorgensen, University of Washington; Robyn L McClelland, University of Washington; Christie M Ballantyne, Baylor College of Medicine; Lin Y Chen, University of Minnesota; John S Gottdiener, University of Maryland; Philip Greenland, Northwestern University; Ron Hoogeveen, Baylor College of Medicine; Nancy S Jenny, University of Vermont; Jorge R Kizer, Albert Einstein College of Medicine; Robert S Rosenson, Icahn School of Medicine at Mount Sinai; Elsayed Z Soliman, Wake Forest School of Medicine; Mary Cushman, University of Vermont; Alvaro Alonso, Emory University; Susan R Heckbert, University of Washington
• Journal Title: American Heart Journal
• Volume: Volume 197
• Publisher: Elsevier: 12 months | 2018-03-01, Pages 62-69
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1016/j.ahj.2017.11.010
• Subjects: Health Sciences, Pathology; Health Sciences, Epidemiology
• Keywords: Science & Technology; Life Sciences & Biomedicine; Cardiac & Cardiovascular Systems; Cardiovascular System & Cardiology; ACTIVATING-FACTOR-ACETYLHYDROLASE; CORONARY-HEART-DISEASE; LOW-DENSITY-LIPOPROTEIN; ATHEROSCLEROSIS RISK; CARDIOVASCULAR-DISEASE; LUDWIGSHAFEN RISK; INFLAMMATION; COMMUNITIES; MORTALITY; HEALTH

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 A 2 (Lp-PLA 2 ) 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-PLA 2 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-PLA 2 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-PLA 2 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-PLA 2 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.