Secretory phospholipase A(2)-IIA and cardiovascular disease: a mendelian randomization study

Michael V Holmes, Tabassome Simon, Holly J Exeter, Lasse Folkersen, Folkert W Asselbergs, Montse Guardiola, Jackie A Cooper, Jutta Palmen, Jaroslav A Hubacek, Kathryn F Carruthers, Benjamin D Horne, Kimberly D Brunisholz, Jessica L Mega, Erik P A van Iperen, Mingyao Li, Maarten Leusink, Stella Trompet, Jeffrey J W Verschuren, G Kees Hovingh, Abbas DehghanChristopher P Nelson, Salma Kotti, Nicolas Danchin, Markus Scholz, Christiane L Haase, Dietrich Rothenbacher, Daniel I Swerdlow, Karoline B Kuchenbaecker, Eleonora Staines-Urias, Anuj Goel, Ferdinand van 't Hooft, Karl Gertow, Ulf de Faire, Andrie G Panayiotou, Elena Tremoli, Damiano Baldassarre, Fabrizio Veglia, Lesca M Holdt, Frank Beutner, Ron T Gansevoort, Gerjan J Navis, Irene Mateo Leach, Lutz P Breitling, Hermann Brenner, Joachim Thiery, Dhayana Dallmeier, Anders Franco-Cereceda, Jolanda M A Boer, Jeffrey W Stephens, Marten H Hofker, Alain Tedgui, Albert Hofman, André G Uitterlinden, Vera Adamkova, Jan Pitha, N Charlotte Onland-Moret, Maarten Jan Cramer, Hendrik M. Nathoe, Wilko Spiering, Olaf H Klungel, Meena Kumari, Peter H Whincup, David A Morrow, Peter S Braund, Alistair S Hall, Anders G Olsson, Pieter A Doevendans, Mieke D Trip, Martin D Tobin, Anders Hamsten, Hugh Watkins, Wolfgang Koenig, Andrew N Nicolaides, Daniel Teupser, Ian N M Day, John F Carlquist, Tom R Gaunt, Ian Ford, Naveed Sattar, Sotirios Tsimikas, Gregory G Schwartz, Debbie A Lawlor, Richard W Morris, Manjinder S Sandhu, Rudolf Poledne, Anke H Maitland-van der Zee, Kay-Tee Khaw, Brendan J Keating, Pim van der Harst, Jackie F Price, Shamir R Mehta, Salim Yusuf, Jaqueline C M Witteman, Oscar H Franco, J Wouter Jukema, Peter de Knijff, Anne Tybjaerg-Hansen, Daniel J Rader, Martin Farrall, Nilesh J Samani, Mika Kivimaki, Keith A A Fox, Steve E Humphries, Jeffrey L Anderson, S Matthijs Boekholdt, Tom M Palmer, Per Eriksson, Guillaume Paré, Aroon D Hingorani, Marc S Sabatine, Ziad Mallat, Juan P Casas, Philippa J Talmud

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

OBJECTIVES: This study sought to investigate the role of secretory phospholipase A2 (sPLA2)-IIA in cardiovascular disease. BACKGROUND: Higher circulating levels of sPLA2-IIA mass or sPLA2 enzyme activity have been associated with increased risk of cardiovascular events. However, it is not clear if this association is causal. A recent phase III clinical trial of an sPLA2 inhibitor (varespladib) was stopped prematurely for lack of efficacy. METHODS: We conducted a Mendelian randomization meta-analysis of 19 general population studies (8,021 incident, 7,513 prevalent major vascular events [MVE] in 74,683 individuals) and 10 acute coronary syndrome (ACS) cohorts (2,520 recurrent MVE in 18,355 individuals) using rs11573156, a variant in PLA2G2A encoding the sPLA2-IIA isoenzyme, as an instrumental variable. RESULTS: PLA2G2A rs11573156 C allele associated with lower circulating sPLA2-IIA mass (38% to 44%) and sPLA2 enzyme activity (3% to 23%) per C allele. The odds ratio (OR) for MVE per rs11573156 C allele was 1.02 (95% confidence interval [CI]: 0.98 to 1.06) in general populations and 0.96 (95% CI: 0.90 to 1.03) in ACS cohorts. In the general population studies, the OR derived from the genetic instrumental variable analysis for MVE for a 1-log unit lower sPLA2-IIA mass was 1.04 (95% CI: 0.96 to 1.13), and differed from the non-genetic observational estimate (OR: 0.69; 95% CI: 0.61 to 0.79). In the ACS cohorts, both the genetic instrumental variable and observational ORs showed a null association with MVE. Instrumental variable analysis failed to show associations between sPLA2 enzyme activity and MVE. CONCLUSIONS: Reducing sPLA2-IIA mass is unlikely to be a useful therapeutic goal for preventing cardiovascular events.
Original languageEnglish
Pages (from-to)1966-1976
Number of pages11
JournalJournal of the American College of Cardiology
Volume62
Issue number21
DOIs
Publication statusPublished - 2013

Keywords

  • Alleles
  • Cardiovascular Diseases
  • DNA
  • Gene Expression Regulation
  • Global Health
  • Humans
  • Incidence
  • Mendelian Randomization Analysis
  • Phospholipases A2, Secretory
  • World Health

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