The Relationship Between The Serum Level Of Pregnancy-associated Plasma Protein-A And The Severity Of Coronary Heart Disease

Background Coronary heart disease (CHD) is a common disease that threatens the people's health seriously, the pathogenesis of which is not yet understood sufficiently. The most common form of CHD is acute coronary syndrome (ACS). ACS is a syndrome in which atherosclerotic plaque ruptures or fissures on its surface, and damages the endothelium. There is subsequent vasospasm, platelet adhesion, aggregation and thrombus formation, which causes acute lesions with complete or partial arterial occlusion and leads to unstable angina pectoris (UAP), non-ST elevation myocardial infarction (NSTEMI), ST elevation myocardial infarction (STEMI) and sudden death. Rupture of vulnerable plaque and subsequent thrombus formation in the coronary artery are considered to be responsible for the pathogenesis of ACS. Pathological studies indicate that most of the patients with ACS are not caused by critical stenosis of coronary artery, but caused by rupture of vulnerable plaque and subsequent thrombus formation in the coronary arteries in which there are only slight or medium stenosis. So, identification of the vulnerable plaque and prediction of the plaque rupture is helpful in interfering with the plaque at an early stage and to prevent or treat ACS. Many studies showed that plaques to be vulnerable or not is determined by the size of lipid core, the number of macrophages, T lymphocytes, collagen fibers and vascular smooth muscle cells (VSMCs) and the level of pregnancy-associated plasma protein A (PAPP-A).