Circulating Levels Of Pregnancy-Associated Plasma Protein-A In Patients With Acute Coronary Syndrome And Its Expression In Atherosclerotic Plaques

Background Acute coronary syndrome (ACS) is a serious health problem. Rupture of atherosclerotic plaques, and resultant platelet aggregation and thrombus formation is believed to be responsible for most of the development of ACS. In the process, plaque rupture is the most important initiating factor. Quite recently it has been demonstrated that pregnancy associated plasma protein-A (PAPP-A), a member of matrix metalloproteinases, is present in unstable plaques, and circulating levels of PAPP-A are elevated in AMI and UA patients. And it is reported the circulating PAPP-A level is a strong independent predictor of recurrent ischemic events among patients with ACS. In order to add more information on the monitoring and predictive values of ACS, we examined the PAPP-A expression in coronary plaques of different histological types, and measured circulating PAPP-A levels in patients with ACS.Material and methods Coronary arteries were obtained at autopsy from 51 patients with coronary artery disease (45 male, 6 female). Sections from atherosclerotic plaques (15 ruptured plaques, unstable plaques and stable plaques, respectively) were made and studied by immunohistochemical staining method using monoclonal human antibody against PAPP-A. The serum levels of PAPP-A were detected by ELISA method. The study included 30 AMI patients (23 male, 7 female), 30 UA (22 male, 8 female), 30 SA (22 male, 8 female) and 30 healthy cases (25 male, 5 female). Blood samples from AMI and UA patients were obtained at (9.6±3.9) hours and (8.6±4.0) hours after the onset of symptoms respectively. Circulating levels of hs-CRP and concentrations of TCH, LDL-CH...