Association between lipoprotein associated phospholipase A2 mass and subclinical coronary and carotid atherosclerosis in Retired National Football League players

Objectives: Retired National Football League (NFL) players were reported to have high prevalence of cardiovascular risk factors. Lipoprotein Associated Phospholipase A₂ (LpPLA₂) has shown to be associated with cardiovascular disease in the general population, but it is unknown whether such an association exists in retired NFL players. Our objective was to assess whether LpPLA₂ mass was associated with coronary artery calcium (CAC) and carotid artery plaque (CAP) in retired NFL players. Methods: LpPLA₂ mass was assessed using a dual monoclonal antibody immunoassay. CAC presence was defined as CAC score>0. CAP was defined as focal thickening ≥50% than that of the surrounding vessel wall with a minimal thickness of 1.2 mm on carotid ultrasound. Results: In 832 NFL players, the median (IQR) age and LpPLA₂ levels were 54 (45-63) years and 142 (109-181) ng/mL respectively. LpPLA₂ mass was positively correlated with low-density lipoprotein (LDL) cholesterol and high-density lipoprotein cholesterol; negatively correlated with LDL particle concentration and body mass index; and not correlated with high-sensitivity C-reactive protein. CAC was present in 659 (79%) and CAP in 544 (65%) players. In a fully adjusted model, LpPLA₂ was not associated with CAC (OR per 1-SD increase, 0.85; 95% CI 0.71-1.02) or CAP (0.90, 0.75-1.08). LpPLA₂ was also not associated with CAC burden in those with CAC>0. Results were similar when highest and lowest LpPLA₂ tertiles were compared, and also in various subgroups. Conclusion: LpPLA₂ mass was not associated with coronary or carotid subclinical atherosclerosis in retired NFL players.