A protein found in blood has been shown to predict CHD risk as accurately as cholesterol and BP levels, suggesting it could be targeted to prevent vascular disease.
A UK study showed that the enzyme lipoprotein-associated phospholipase A2 (Lp-PLA2) increased the risk of CHD, stroke and vascular death. The increased risk of CHD was similar to that caused by high non-HDL cholesterol and high BP.
Researchers from the University of Cambridge said the findings reinforced interest in the enzyme as a potential target for preventing heart disease.
Lp-PLA2 is secreted by atherosclerotic plaques and has been found to produce pro-inflammatory compounds implicated in vascular disease. The study is the first to examine the enzyme's role as a risk factor for CHD, stroke and mortality.
Researchers led by Dr Alex Thompson examined data from 79,036 patients from 32 studies of vascular disease, including measurements of Lp-PLA2 levels in the blood. The patient population included healthy individuals, patients with a history of stable vascular disease and patients who had suffered a recent acute ischaemic event.
Analysis of the data uncovered 17,722 vascular events and deaths, which the researchers studied to calculate risk ratios for Lp-PLA2. Primary outcome was CHD; stroke and vascular death were secondary outcomes.
The researchers found that higher levels of Lp-PLA2 were associated with a raised risk of CHD and stroke. The risk linked with Lp-PLA2 was independent of other inflammatory markers, such as C-reactive protein.
Measurements of the enzyme could therefore offer a new insight into the role of inflammation in the development of CHD, the authors said.
Dr Thompson concluded: 'Randomised clinical trials of Lp-PLA2 inhibitors should help establish whether lowering Lp-PLA2 levels can reduce risk of vascular disease.'