Potential role for plasma placental growth factor in predicting coronary heart disease risk in women.

OBJECTIVE: The purpose of this study was to examine placental growth factor's (PlGF) predictive value in relation to coronary heart disease (CHD) risk in healthy women. METHODS AND
RESULTS: Among 32 826 women from the Nurses' Health Study who provided blood samples at baseline, 453 CHD events were documented during 14 years of follow-up. Controls were matched to cases (2:1) for age, smoking, fasting status, and date of blood sampling. PlGF was inversely correlated with HDL-cholesterol (HDL-C), and positively correlated with several coronary risk factors. In multivariate models, women in the highest versus lowest quintile of PlGF had a greater risk of CHD (RR: 1.58; 95% CI: 1.03 to 2.41). Additional adjustment for many coronary risk factors did not substantively alter this relationship, but HDL-C attenuated the association (RR: 1.25; 95% CI: 0.81 to 1.94). In exploratory time to event analysis, higher PlGF levels, measured >10 years before CHD event, but not <10 years preclinical event, were associated with increased risk of CHD, even after adjustment for comorbid conditions and HDL-C levels (RR: 2.79; 95% CI: 1.19 to 6.56).
CONCLUSIONS: Elevated prediagnostic PlGF levels were modestly associated with subsequent risk of CHD events and results were attenuated after controlling for HDL-C. PlGF may be most strongly associated with long-term prediction of CHD, consistent with a potential role in early plaque formation and growth.