C-Reactive Protein and Lipoprotein-Associated Phospholipase A2 in Smokers and Nonsmokers of the Ludwigshafen Risk and Cardiovascular Health Study

  • M. E. KleberEmail author
  • R. Siekmeier
  • G. Delgado
  • T. B. Grammer
  • B. R. Winkelmann
  • H. Scharnagl
  • B. O. Boehm
  • W. März
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 832)


Measurement of high sensitivity CRP (hsCRP) and lipoprotein-associated phospholipase A2 (LpPLA2) provides information on systemic inflammation and stability of atherosclerotic plaques. Data analyzing the effect of smoking on these parameters are sparse. The aim of our study was the analysis of these parameters in active smokers and never-smokers. The study included 777 smokers and 1,178 never-smokers, of whom 221 and 302 died during a follow-up, respectively. The values of LpPLA2 and hsCRP were significantly higher in smokers than in never-smokers. Mortality was highest in smokers and never-smokers with elevation of both biomarkers. Multivariate adjusted hazard ratios for patients in the highest tertile of both hsCRP and LpPLA2 compared with patients in the lowest tertile of both markers were 1.85 (1.04–3.28) in never-smokers and 1.94 (1.10–3.45) in smokers. Our data confirmed the predictive value of hsCRP and LpPLA2. However, there were a relevant number of patients with an increase of only one of these parameters. Therefore, beside other risk factors for cardiovascular disease, both parameters should be determined at least in high risk patients.


Cardiovascular disease hsCRP Inflammation LpPLA2 Mortality Plaque stability Smoking 



We extend our appreciation to the participants of the LURIC study. We thank the LURIC study team who were either temporarily or permanently involved in patient recruitment as well as sample and data handling, in addition to the laboratory staff at the Ludwigshafen General Hospital and the Universities of Freiburg and Ulm, Germany. LURIC has received funding from the 6th Framework Program (integrated project Bloodomics, grant LSHM-CT-2004-503485) and from the 7th Framework Program (Atheroremo, grant agreement number 201668 and RiskyCAD, grant agreement number 305739) of the European Union.

Conflicts of Interest

The authors declare no conflicts of interest in relation to this article.


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Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • M. E. Kleber
    • 1
    Email author
  • R. Siekmeier
    • 2
  • G. Delgado
    • 1
  • T. B. Grammer
    • 1
  • B. R. Winkelmann
    • 3
  • H. Scharnagl
    • 4
  • B. O. Boehm
    • 5
    • 6
  • W. März
    • 1
    • 4
    • 7
  1. 1.Fifth Department of Medicine (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology), Medical Faculty of MannheimHeidelberg UniversityMannheimGermany
  2. 2.Drug Regulatory AffairsUniversity of BonnBonnGermany
  3. 3.Cardiology GroupFrankfurt-SachsenhausenGermany
  4. 4.Clinical Institute of Medical and Chemical Laboratory DiagnosticsMedical University GrazGrazAustria
  5. 5.Division of Endocrinology, Department of MedicineUniversity HospitalUlmGermany
  6. 6.LKC School of MedicineImperial College London and Nanyang Technological UniversitySingaporeSingapore
  7. 7.Synlab AcademyMannheimGermany

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