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Winkler, K; Winkelmann, BR; Scharnagl, H; Hoffmann, MM; Grawitz, AB; Nauck, M; Böhm, BO; März, W.
Platelet-activating factor acetylhydrolase activity indicates angiographic coronary artery disease independently of systemic inflammation and other risk factors: the Ludwigshafen Risk and Cardiovascular Health Study.
CIRCULATION. 2005; 111(8): 980-987.
Doi: 10.1161/01.CIR.0000156457.35971.C8
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- Co-authors Med Uni Graz
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März Winfried
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Scharnagl Hubert
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- Abstract:
- BACKGROUND: Platelet-activating factor acetylhydrolase (PAF-AH), also denoted as lipoprotein-associated phospholipase A2, is a lipoprotein-bound enzyme that is possibly involved in inflammation and atherosclerosis. This study investigates the relationship of PAF-AH activity to angiographic coronary artery disease (CAD), the use of cardiovascular drugs, and other established risk factors. METHODS AND RESULTS: PAF-AH activity, lipoproteins, sensitive C-reactive protein (sCRP), fibrinogen, serum amyloid A, and white blood cell count were determined in 2454 subjects with angiographically confirmed CAD and in 694 control subjects. PAF-AH activity was highly correlated with LDL cholesterol (r=0.517), apolipoprotein B (r=0.644), and non-HDL cholesterol (r=0.648) but not with sCRP or fibrinogen. PAF-AH activity was lower in women than in men and was affected by the intake of lipid-lowering drugs (-12%; P<0.001), aspirin (-6%; P<0.001), beta-blockers (-6%; P<0.001), and digitalis (+7%; P<0.001). Unlike sCRP, fibrinogen, and serum amyloid A, PAF-AH activity was not elevated in unstable angina, non-ST-elevation myocardial infarction, or ST-elevation myocardial infarction. When nonusers of lipid-lowering drugs were examined, PAF-AH activity was associated with the severity of CAD and the number of coronary vessels with significant stenoses. In individuals not taking lipid-lowering drugs and after adjustment for use of aspirin, beta-blocker, and digitalis, the odds ratio for CAD associated with increasing PAF-AH activity was 1.39 (95% CI 1.26 to 1.54, P<0.001), a finding that was robust against further adjustments. CONCLUSIONS: PAF-AH activity is not an indicator of the systemic inflammation that accompanies acute coronary syndromes. PAF-AH activity is affected by a number of cardiovascular drugs; however, after such medication use was accounted for, PAF-AH activity was associated with angiographic CAD, complementary to sCRP and independently of established risk factors such as LDL cholesterol.
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1-Alkyl-2-acetylglycerophosphocholine Esterase - blood
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Aged - blood
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Angina, Unstable - blood
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Antilipemic Agents - therapeutic use
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Biological Markers - blood
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Coronary Arteriosclerosis - blood
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Female - blood
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Humans - blood
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Inflammation - blood
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Lipoproteins - blood
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Male - blood
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Middle Aged - blood
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Myocardial Infarction - blood
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Risk Factors - blood
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lipoproteins
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C-reactive protein
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cholesterol