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Serum plasma pregnancy-associated protein A: a potential marker of echogenic carotid atherosclerotic plaques in asymptomatic hyperlipidemic subjects at high cardiovascular risk.
- Source :
-
Arteriosclerosis, thrombosis, and vascular biology [Arterioscler Thromb Vasc Biol] 2003 Jan 01; Vol. 23 (1), pp. e7-10. - Publication Year :
- 2003
-
Abstract
- Objective: The proteolytic activity of metalloproteinases, proinflammatory enzymes that degrade extracellular matrix, is elevated in lipid-rich atherosclerotic plaques, thereby contributing to plaque fragility and rupture. Pregnancy-associated plasma protein (PAPP-A) is a metalloproteinase, expressed in unstable atherosclerotic plaques, whose circulating levels are elevated in acute coronary syndromes. We evaluated serum PAPP-A levels as a marker of the premature development of atherosclerosis in hyperlipidemic subjects at elevated cardiovascular risk.<br />Methods and Results: Serum PAPP-A levels were determined in asymptomatic hyperlipidemic male subjects (n=64; mean+/-SD age, 51+/-7 years) in whom intima-media thickness (IMT) and lesion status in the carotid artery were evaluated by noninvasive ultrasonography and compared with those of a normolipidemic control group (n=25). No difference was observed in circulating PAPP-A levels between hyperlipidemic subjects and controls (8.99+/-2.93 and 8.03+/-2.75 mIU/L, respectively; mean+/-SD) nor between hyperlipidemic subjects who presented with a luminal obstruction of the carotid artery (9.26+/-2.53 mIU/L) and those who did not (8.85+/-3.29 mIU/L). By contrast, in patients with atheromatous carotid plaques, a positive association between serum levels of PAPP-A and C-reactive protein was observed (P<0.05); moreover, subjects exhibiting hyperechoic or isoechoic, echogenic lesions had significantly higher PAPP-A levels compared with those with hypoechoic lesions (10.32+/-2.72 vs 8.27+/-2.18 mIU/L, P<0.05) and with normolipidemic controls (P<0.05).<br />Conclusions: Elevated serum PAPP-A levels represent a potential marker of the degree of echogenicity of carotid atherosclerotic plaques in asymptomatic hyperlipidemic patients at high cardiovascular risk and equally of an enhanced local inflammatory state involving remodeling of subendothelial extracellular matrix.
- Subjects :
- Biomarkers blood
Carotid Artery Diseases enzymology
Carotid Artery Diseases pathology
Endothelium, Vascular enzymology
Endothelium, Vascular pathology
Extracellular Matrix enzymology
Extracellular Matrix pathology
Humans
Male
Metalloendopeptidases metabolism
Middle Aged
Predictive Value of Tests
Risk Factors
Ultrasonography
Arteriosclerosis blood
Arteriosclerosis diagnostic imaging
Carotid Artery Diseases blood
Carotid Artery Diseases diagnostic imaging
Hyperlipidemias blood
Pregnancy-Associated Plasma Protein-A metabolism
Subjects
Details
- Language :
- English
- ISSN :
- 1524-4636
- Volume :
- 23
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Arteriosclerosis, thrombosis, and vascular biology
- Publication Type :
- Academic Journal
- Accession number :
- 12524241
- Full Text :
- https://doi.org/10.1161/01.atv.0000047448.76485.b8