Lipoprotein-associated phospholipase A2 and risks of coronary heart disease and ischemic stroke in the general population: A systematic review and meta-analysis

Background: This study investigated the associations between lipoprotein-associated phospholipase A2 (Lp-PLA2) and the risks of coronary heart disease (CHD) and ischemic stroke (IS) in the general population.

Methods: PubMed, Embase, and the Cochrane Library databases were searched for prospective cohort studies published prior to June 2016. Multivariate-adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for CHD and IS risks according to Lp-PLA2 activity or mass were extracted, pooled, and weighted using random-effects modeling.

Results: Twelve studies examining Lp-PLA2 activity or mass and long-term risks of CHD and IS were included. Combined HRs for CHD and IS risks for the highest category referring to lowest category of Lp-PLA2 were 1.46 (95% CI: 1.20-1.78, P<0.001) and 1.58 (95% CI: 1.21-2.07, P=0.001), respectively. The same patterns were observed for both mass and activity, with the exception of those for CHD. For every 1-standard deviation (SD) increase in Lp-PLA2 activity, CHD risk increased by 12% (HR: 1.12, 95% CI: 1.05-1.22, P=0.002); no association between 1-SD increases in Lp-PLA2 activity and IS was observed. Lp-PLA2 mass was associated with CHD risk (HR: 1.02-1.24, 95% CI: 1.02-1.24, P=0.021). Lp-PLA2 mass per 1-SD increase was not associated with IS risk.

Conclusions: Greater Lp-PLA2 activity or mass was associated with an increased risk of CHD and IS; however, additional well-designed trials are warranted to confirm this association.