Pregnancy-associated plasma protein A and its endogenous inhibitor, the proform of eosinophil major basic protein (proMBP), are related to complex stenosis morphology in patients with stable angina pectoris

Article

关键词: ATHEROSCLEROTIC PLAQUE RUPTURE;    CORONARY-ARTERY-DISEASE;    C-REACTIVE PROTEIN;    GROWTH-FACTOR-I;    PAPP-A;    ANGIOGRAPHIC MORPHOLOGY;    MYOCARDIAL-INFARCTION;    INCREASED EXPRESSION;    UNSTABLE ANGINA;    METALLOPROTEINASE;   

DOI  :  10.1161/01.CIR.0000124716.67921.D2

来源: SCIE

【 摘 要 】

Background - The metalloproteinase pregnancy-associated plasma protein-A (PAPP-A) has been implicated in coronary plaque disruption. Its endogenous inhibitor, the proform of eosinophil major basic protein ( proMBP), may also play a role in this process. Atheromatous plaque disruption often presents as complex angiographic lesions. We sought to assess whether PAPP-A, proMBP, and PAPP-A/ProMBP ratio are markers of angiographic plaque complexity in patients with chronic stable angina. Methods and Results - We studied 396 stable angina patients ( age 63 +/- 10 years, 230 men) of whom 289 had angiographically documented coronary artery disease (greater than or equal to75% stenosis). All coronary stenoses greater than or equal to30% diameter reduction (n = 531 in 322 patients) were assessed and classified as complex (n = 228) or smooth (n = 303) by previously validated criteria. PAPP-A, proMBP, and C-reactive protein (hs-CRP) serum levels were measured by ELISA. Patients with complex coronary stenoses had a significantly (P < 0.001) higher PAPP-A/proMBP ratio (3.1 +/- 1.2 versus 2.7 +/- 0.8 x 10(-3)) and PAPP-A levels (5.9 +/- 1.6 versus 5.1 +/- 1.4 mIU/L) than those without. On univariate analysis, male gender (P < 0.001), age (P < 0.001), previous history of myocardial infarction (P = 0.013), reduced ejection fraction (P < 0.001), severe coronary artery disease ( P < 0.001), aspirin treatment ( P < 0.001), PAPP-A levels (P < 0.001), and PAPP-A/proMBP ratio (P < 0.001) were correlated with the number of complex stenoses. Multiple regression analysis showed that male gender, age, severe coronary artery disease, and PAPP-A/proMBP ratio were independent predictors of the number of angiographically complex stenoses. Conclusions - In patients with stable angina, PAPP- A and PAPP- A/proMBP ratio are associated with angiographic plaque complexity.

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