Atorvastatin Acute Coronary Syndrome, Serum Pregnancy Associated Plasma Protein A And High-sensitivity C-reactive Protein

Background:In recent years, the coronary atherosclerosis reduces the occurrence of mechanisms as a study of the progress that was to realise inflammatory reaction as the occurrence, development and formation process in an acute complications to play an important role. In addition, attention focused on the inflammatory markers through to predict the risk of cardiovascular events, the current research in this area including hs-CRP, serum amyloid A, interleukin-6, pregnancy-associated plasma Protein A (Pregnancy-associatedplasmaprotein-A), matrix metalloproteinase. PAPP-A is an insulin-like growth factor (insulin-like growth factor, IGF)-related zinc metal redundant together with protease, is a member of the metalloproteinase superfamily. PAPP-A currently study showed that vulnerable plaque in coronary tissues increased in acute coronary syndrome and serum levels, which PAPP-A as a new serological marker of unstable plaque. By detecting the hs-CRP, prospective studies have shown that increased levels of hs-CRP and cardiovascular disease associated with the occurrence and development, is an independent risk factor. Since PAPP-A and hs-CRP protein dynamics in the unstable plaque has a special meaning, the effects of drugs for their study has important clinical significance.Objective:Acute coronary syndromes(ACS),defined as unstable angina(UA),non-ST-elevation mycardial infarction(NSTEMI)and ST-elevation mycardial infarction(STEMI),remin the leading cause of mortality and morbidity.recent studies of PAPP-A and c-CRP extended its role into vascular inflammation and coronary artery disease.PAPP-A was selectively in unstable plaques.However,statin effects on PAPP-A and c-CRP were pooly described.Pregnancy-associatedplasmaprotein-A(PAPP-A) was associated with atherosclerotic plaque vulnerability,whereas statin therapy was associated with increased plaque stability.the aim of my study was therefore,to assessthe effect of statin treatment for PAPP-A at hospital of patients with ACS.Methods:one handrd-four patients presenting with clinical indications(non-ST-elevation myocardial infarction,unstable angina,and stable angina)for invasive coronary angiography and subsequent were randomly assigned to atorvastatin 10,20,or40mg/day.serum PAPP-A,cCRP level was determined by ELISA PAPP-A,high-sensitivityC-reactiveprotein(hs-CRP),and cardiac troponins (cTn) were measured at baseline and 1 and 4 weeks.Results:PAPP-A and hs-CRP was significantly increased in 73 patients with acute cononary syndrome(ACS)compared with 31 patients with stable angina(P<0.03, P<0.001).patients randomly assigned to atorvastatin 10mg,20mg did not show asignificant decrease in PAPP-A from baseline at 1 or 4 weeks(P>0.2).patients treated with atorvastatin 40mg showed a significantly different between the ACS and SA.(P<0.001, P<0.002). ACS serum PAPP-A, troponin, hs-CRP no correlation between levelsConclusions:PAPP-A significantly increased in patients with ACS compared with those with SA.High-dose atorvastatin significantly decreased PAPP-A at 4weeks.low-dose atorvastatin did not produce this effect.