An increased level of lipoprotein-associated phospholipase A2 (LpPLA2) indicates an increased risk of coronary heart disease, say United Kingdom researchers. Chronic inflammation is thought to increase the risk of coronary events by making atherosclerotic plaques prone to rupture. Therefore, the role of inflammatory markers in coronary heart disease was assessed in a prospective study using samples from a biological bank of the West of Scotland Coronary Prevention Study (WOSCOPS). Professor Chris Packard (department of pathological biochemistry, Glasgow Royal infirmary) and colleagues report that the level of LpPLA2, an enzyme regulated by mediators of inflammation, had a strong positive association with risk of coronary heart disease. Other inflammatory markers, such as C-reactive protein, white cell count and fibrinogen levels, were also found to be predictors of coronary events but, when other risk factors were considered, they were not significantly associated with risk. The authors say that their findings provide a new measurable indicator of coronary heart disease. In a press release issued by the British Heart Foundation, which part-funded the study, Professor Packard said that the study had implications for better targeting of expensive drugs used in the prevention of heart disease and for assessing who might be at risk of developing heart disease. The identification of LpPLA2 provided a novel target for drug development, he said. The paper is published in the New England Journal of Medicine (2000;343:1148).