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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.

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.

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).

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.

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  • Authors+Show Affiliations

    ,

    Department of Clinical Biochemistry, the National Institute for Health, Paris, France. jean-louis.beaudeux@psl.ap-hop-paris.fr

    , , , , ,

    Source

    MeSH

    Arteriosclerosis
    Biomarkers
    Carotid Artery Diseases
    Endothelium, Vascular
    Extracellular Matrix
    Humans
    Hyperlipidemias
    Male
    Metalloendopeptidases
    Middle Aged
    Predictive Value of Tests
    Pregnancy-Associated Plasma Protein-A
    Risk Factors
    Ultrasonography

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    12524241

    Citation

    Beaudeux, Jean-Louis, et al. "Serum Plasma Pregnancy-associated Protein A: a Potential Marker of Echogenic Carotid Atherosclerotic Plaques in Asymptomatic Hyperlipidemic Subjects at High Cardiovascular Risk." Arteriosclerosis, Thrombosis, and Vascular Biology, vol. 23, no. 1, 2003, pp. e7-10.
    Beaudeux JL, Burc L, Imbert-Bismut F, et al. Serum plasma pregnancy-associated protein A: a potential marker of echogenic carotid atherosclerotic plaques in asymptomatic hyperlipidemic subjects at high cardiovascular risk. Arterioscler Thromb Vasc Biol. 2003;23(1):e7-10.
    Beaudeux, J. L., Burc, L., Imbert-Bismut, F., Giral, P., Bernard, M., Bruckert, E., & Chapman, M. J. (2003). Serum plasma pregnancy-associated protein A: a potential marker of echogenic carotid atherosclerotic plaques in asymptomatic hyperlipidemic subjects at high cardiovascular risk. Arteriosclerosis, Thrombosis, and Vascular Biology, 23(1), pp. e7-10.
    Beaudeux JL, et al. Serum Plasma Pregnancy-associated Protein A: a Potential Marker of Echogenic Carotid Atherosclerotic Plaques in Asymptomatic Hyperlipidemic Subjects at High Cardiovascular Risk. Arterioscler Thromb Vasc Biol. 2003 Jan 1;23(1):e7-10. PubMed PMID: 12524241.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Serum plasma pregnancy-associated protein A: a potential marker of echogenic carotid atherosclerotic plaques in asymptomatic hyperlipidemic subjects at high cardiovascular risk. AU - Beaudeux,Jean-Louis, AU - Burc,Laurence, AU - Imbert-Bismut,Françoise, AU - Giral,Philippe, AU - Bernard,Maguy, AU - Bruckert,Eric, AU - Chapman,M John, PY - 2003/1/14/pubmed PY - 2003/1/28/medline PY - 2003/1/14/entrez SP - e7 EP - 10 JF - Arteriosclerosis, thrombosis, and vascular biology JO - Arterioscler. Thromb. Vasc. Biol. VL - 23 IS - 1 N2 - 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. 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). 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. SN - 1524-4636 UR - https://www.unboundmedicine.com/medline/citation/12524241/Serum_plasma_pregnancy_associated_protein_A:_a_potential_marker_of_echogenic_carotid_atherosclerotic_plaques_in_asymptomatic_hyperlipidemic_subjects_at_high_cardiovascular_risk_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=12524241.ui DB - PRIME DP - Unbound Medicine ER -