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Interplay between PAPP-A, inflammation and adiposity in patients with angiographically proven acute coronary syndrome

Khageshwar Mahato1, Moushumi Lodh1, Ashok Parida1

  • 1.

Hormone Molecular Biology and Clinical Investigation
|June 21, 2017
PubMed

Insights

This study reveals a significant interplay between inflammation, obesity, and pregnancy-associated plasma protein-A (PAPP-A) in acute coronary syndrome (ACS) patients. Combined risk factors, including PAPP-A, hs-CRP, and BMI, dramatically increase ACS risk.

Area of Science:

  • Cardiology
  • Biochemistry
  • Metabolic Syndrome

Background:

  • Inflammation, obesity, and insulin resistance are implicated in acute coronary syndrome (ACS) pathogenesis.
  • Single-pathway interventions for ACS have limited long-term efficacy, suggesting synergistic interactions between risk factors.
  • Understanding these complex interactions is crucial for developing effective combinatorial therapeutic approaches.

Purpose of the Study:

  • To investigate the interplay between pregnancy-associated plasma protein-A (PAPP-A), inflammation, and adiposity in patients with ACS.
  • To determine if PAPP-A, hs-CRP, and BMI collectively influence ACS risk.
  • To explore the relationship between these factors and plaque instability in ACS.

Main Methods:

  • A case-control study involving 128 subjects (64 ACS patients, 64 controls) in a tertiary care hospital.
  • Estimation of PAPP-A and high-sensitivity C-reactive protein (hs-CRP) using enzyme-linked immunosorbent assay (ELISA) kits.
  • Analysis of correlations between PAPP-A, hs-CRP, insulin, ApoB, Lp(a), and body mass index (BMI).

Main Results:

  • Mean levels of PAPP-A and hs-CRP were significantly elevated in ACS patients compared to controls.
  • PAPP-A showed a positive correlation with hs-CRP, insulin, ApoB, and Lp(a).
  • The combined assessment of hs-CRP, PAPP-A, and BMI yielded a significantly higher relative risk (14.2, p<0.001) for ACS compared to individual factors.

Conclusions:

  • A significant interplay exists between chronic inflammation, obesity, and plaque instability in ACS patients.
  • Increased BMI exacerbates plaque rupture risk in the presence of elevated PAPP-A and inflammation.
  • These findings support a combinatorial approach to managing ACS risk by addressing multiple interacting factors.
Keywords:
acute coronary syndromebody mass indexhsC reactive proteinpregnancy associated plasma protein-Arelative risk

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