Pregnancy Associated Plasma Protein-a Predicts Vulnerable Plaque In Coronary Heart Disease

Objective:The risk of CAD is from vulnerabel plaque, resulting of Embolic lesions and Vasospasm.So,early identification of vulnerable plaque on the prevention and treatment of acute coronary syndrome have important clinical implications.Studies have shown that in vulnerable plaque, about95%fiber cap thickness is less than65μm. Optical coherence tomography Imaging resolution is up to10μm,which can show us the lipid content、fiber cap thickness in the vulnerable plaque clearly,and its result of histological examination is consistent.So,we can estimate fiber cap thickness by OCT to find vulnerable plaque.But,its wound、high expenses restrict its application. Though vulnerability of coronary plaque has a close relationship with a series of inflammatory response, we could estimate the characters of vulnerable plaque by OCT and then look for the relationships between the characters and inflammatory response. Through this, we could find inflammatory factors that can predict the risk of coronary heart disease and vulnerable plaque. PAPP-A is studied more and more as an inflammatory factor which is a prediction of plaque vulnerability.In this study, we will estimate fiber cap thickness by OCT、detect the difference of PAPP-A level in blood between different CAD groups and look for the relationship between PAPP-A and coronary heart disease and vulnerable plaques.Methods:The levels of PAPP-A and hs-CRP in39patients with coronary artery disease (CAD) who were treated by coronary angiography were determined by enzyme linked immunosoebent assay(ELISA), and OCT was used to measure the fibrous cap thickness of coronary artery atherosclerotic plaques from ACS and SAP patients.Results:The levels of PAPP-A and hs-CRP in ACS patients were significantly higher than those in SAP patients (P<0.01). Fibrous cap thickness of plaques in ACS patients was thiner than that in SAP patients (P<0.01). Besides, The levels of PAPP-A (r=-0.778, P<0.01) and hs-CRP (r=-0.563, P<0.01) were correlated inversely with fibrous cap thickness in ACS patients.Conclusion:1、PAPP-A and hs-CRP are closely related to atherosclerosis, they participate in the process of AS.2、The levels of PAPP-A (r=-0.778, P<0.01) and hs-CRP (r=-0.563, P <0.01) were correlated inversely with fibrous cap thickness, illustrates the links between them and the plaque vulnerability.3、PAPP-A is an independent、effective mark which can predict the risk of CAD and vulnerable plaque.