Discriminative value of serum amyloid A and other acute-phase proteins for coronary heart disease

We studied the value of serum amyloid A (SAA), a first-class acute-phase protein. as a marker for coronary heart disease (CHD) in a middle-aged male population. In a working population of 16 307 men (age. 35-59 years), 446 cases had a history of CHD or prominent Q:QS waves on electrocardiogram. For each case, two thatched controls here investigated. SAA. measured by immunonephelometry, was correlated with other acute-phase proteins, cardiovascular risk factors, and infectious serology markers. SAA concentrations were significantly higher in the cases than in controls (P < 0.05) and correlated with serum C-reactive protein (CRP) (r = 0.61), plasma fibrinogen (r = 0.39). serum haptoglobin (r = 0.36). and body mass index (r = 0.1 3) (P < 0.001). Serum CRP is a better marker for CHD than SAA, which showed discriminative porter only in a univariate model comparing highest versus lowest tertile (odds ratio, 1.39; 95% confidence interval, 1.03-1.87). Neither SAA nor other acute-phase proteins correlated with Chlamydia pneumoniae immunoglobulin (Ig)G, Helicobacter pylori IgG and IgA, and cytomegalovirus IgG. In conclusion, although SAA has a discriminative value for CHD, serum CRP is to be preferred as a first-class acute-phase reactant for detection of the disease. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.