Pregnancy-Associated Plasma Protein-A as an Inflammatory Biomarker in Patients Undergoing Coronary Artery Bypass Surgery
Main Article Content
Keywords
Coronary artery disease, coronary artery bypass grafting, cardiac biomarker
Abstract
Study Objectives: Data is limited to show whether PAPA-A and/or VEGF are useful tests to predict the prognosis of coronary artery disease. We sought to investigate the potential roles of PAPP-A and VEGF in predicting the severity of coronary artery disease in patients undergoing coronary artery bypass grafting. Methods: A total of 212 male patients who were scheduled to undergo coronary angiography were included. Patients were divided into five groups. Group 0: Patients with normal coronary arteries, Group 1: Patients with <50% stenosis in only one coronary artery, Group 2: Patients with >50% stenosis in 1 or 2 coronary arteries, Group 3: Patients with >50% stenosis in 3 or 4 coronary arteries, Group 4: Patients with >50% stenosis in 5 or more coronary arteries. PAPP-A, TNF-α, IL-6, and VEGF, blood samples were centrifuged at a rate of 3500 rpm for 10 minutes. Results: In the preoperative measurements, all inflammatory biomarkers except VEGF were significantly associated with an increasing number of diseased coronary arteries where hsCRP and PAPP-A showed the highest level of association. In the 7th postoperative day measurements, only PAPP-A and IL-6 showed significant association with the dependent outcome. PAPP-A was found to be associated with an increased risk of a higher number of diseased coronary arteries. Conclusion: PAPP-A offers a useful tool in the diagnosis of the severity of coronary artery involvement in patients undergoing CABG. Its use alone or in combination with TNF- α and/or CRP may potentially distinguish patients with and without advanced disease.
References
2. Danenberg HD, Szalai AJ, Swaminathan RV, et al. Increased thrombosis after arterial injury in human C-reactive protein-transgenic mice. Circulation. 2003; 108:512–515.
3. Cortez-Cooper M, Meaders E, Stallings J, et al. Soluble TNF and IL-6 receptors: Indicators of vascular health in women without cardiovascular disease. Vasc Med. 2013;18(5):282-9. doi: 10.1177/1358863X13508336
4.Theiss AL, Simmons JG, Jobim C, Lund PK. Tumor necrosis factor (TNF) α increases collagen accumulation and proliferation in intestinal myofibroblasts via THF receptor 2. J Biol Chem 2005; 280: 36,099–36,109.
5. Roberts WL. CDC/AHA Workshop on Markers of Inflammatory and Cardiovascular Disease: Application to Clinical and Public Health Practice: laboratory tests available to assess inflammation--performance and standardization: a background paper. Circulation. 2004;21:110(25):e572-6.
6. Danenberg HD, Szalai AJ, Swaminathan RV, et al. Increased thrombosis after arterial injury in human C-reactive protein-transgenic mice. Circulation. 2003; 108:512–515.
7. Bayes-Genis A, Coroner CA, Overgaard MT, et al: Pregnancy-associated plasma protein A as a marker of acute coronary syndromes. N Engl J Med 2001;345:1022-1029.
8. Delafontaine P, Song YH, and Li Y. Expression, regulation, and function of IGF-1, IGF-1R, and IGF-1 binding proteins in blood vessels. Arterioscler Thromb Vasc Biol 24: 435–444, 2004.
9. 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: e7-10.
10. Kanazawa H, Asai K, Hirata K, Yoshikawa J. Possible effects of vascular endothelial growth factor in the pathogenesis of chronic obstructive pulmonary disease. Am J Med 2003; 114: 354-8. [CrossRef]
11. Pedersen BK. Muscle as a secretory organ. Compr Physiol 2013;3(3):1337-62
12. Pearson TA, Mensah GA, Alexander RW, Anderson JL, Cannon RO, III, Criqui M, et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation. 2003;107:499-511.
13. Strohacker K, McFarlin BK. Influence of obesity, physical inactivity, and weight cycling on chronic inflammation. Frontiers in Bioscience 2010;2:98-104.
14. DeClercq V, Taylor C, Zahradka P. Adipose tissue: the link between obesity and cardiovascular disease. Cardiovascular & Hematological Disorders Drug Targets 2008;8(3):228–237.
15. Wellens RI, Roche AF, Khamis HJ, Jackson AS, Pollock ML, Siervogel RM. Relationships between the Body Mass Index and body composition. Obes Res. 1996;4(1):35-44.
16. Ozcelik F, Yuksel C, Arslan E, Genç S, Omer B, Serdar MA. Relationship between visceral adipose tissue and, adiponectin, inflammatory markers and thyroid hormones in obese males with hepatosteatosis and insulin resistance. Arch Med Res. 2013;44(4):273-80.
17. M. G. Shlipak, J. H. Ix, K. Bibbins-Domingo, F. Lin, and M.A. Whooley, “Biomarkers to predict recurrent cardiovascular disease: the heart and soul study,” American Journal ofMedicine, vol. 121, no. 1, pp. 50–57, 2008.
18. J. K. Lee, R. Bettencourt, D. Brenner, T. A. Le, E.Barrett-Connor, and R. Loomba, “Association between serum interleukin-6 concentrations and mortality in older adults: the rancho bernardo study,” PLoS ONE, vol. 7, Article IDe34218, 2012.
19. Conover CA, Bale LK, Harrington SC, Resch ZT, Overgaard MT, Oxvig C. Cytokine stimulation of pregnancy-associated plasma protein A expression in human coronary artery smooth muscle cells: inhibition by resveratrol. Am. J. Physiol. Cell Physiol 2006;290:C183–C188.
20. Boldt HB, Conover CA. Pregnancy-associated plasma protein-A (PAPP-A): a local regulator of IGF bioavailability through cleavage of IGFBPs. Growth Horm. IGF Res 2007;17:10–18.
21. Aono H, Ohwada T, Kaneko N, Fuji T, Iwasaki M. The post-operative changes in the level of inflammatory markers after posterior lumbar interbody fusion. J Bone Joint Surg Br. 2007 Nov;89(11):1478-81.
22. Thelander U, Larsson S. Quantitation of C-reactive protein levels and erythrocyte sedimentation rate after spinal surgery. Spine1992;17:400–4.
23. Liu ZY, Zhang JY, Sun TW, Zhang YJ, Wang LX. Level of pregnancy-associated plasma protein A in patients with coronary artery disease. Clin Invest Med. 2008;31(2):E85-9.
24. Bayes-Genis A, Conover CA, Overgaard MT, et al. Pregnancy-associated plasma protein A as a marker of acute coronary syndromes. N Engl J Med 2001;345:1022–1029.
25. Li XP1, Zhou SH, Tang JJ, et al. Association between plasma pregnancy-associated plasma protein a and restenosis after percutaneous coronary angioplasty. Circ J. 2008 May;72(5):729-33.
Article Sidebar
Article Details
How to Cite
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
