Relationship among pregnancy associated plasma protein-A levels, clinical characteristics, and coronary artery disease extent in patients with chronic stable angina pectoris

Aims To assess, in chronic stable angina (CSA) patients, the relationship among clinical characteristics and cardiovascular risk factors, extent of coronary artery disease (CAD), and pregnancy-associated plasma protein-A (PAPP-A) levels. Methods and results We studied 643 CSA patients (63 +/- 10 years, 482 men) undergoing diagnostic coronary angiography; 97 with angiographically normal coronary arteries or < 50% stenosis, 127 with single vessel disease (VD), and 419 with multi-VD. Patients' age, gender, cardiovascular risk factors, body mass index, history of previous myocardial infarction, angina class, left ventricular ejection fraction (LVEF), and treatment were assessed at study entry. PAPP-A levels (mIU/L) were higher in men than in women (6.2 +/- 2.4 vs. 5.2 +/- 1.8; P < 0.001) and in hypertensive vs. normotensive patients (6.4 +/- 2.8 vs. 5.8 +/- 2.1; P=0.01). PAPP-A correlated directly with age (r=0.19, P < 0.001) and inversely with LVEF (r=-0.11, P=0.01). Patients with multivessel disease (VD) had higher PAPP-A levels (6.45 +/- 2.58) than those with single-VD (5.49 +/- 1.54, P < 0.001) or normal coronaries (4.62 +/- 1.17, P < 0.001). Male gender, age, history of a previous MI, hypercholesterolaemia, and PAPP-A levels were independent predictors for the presence of CAD. Conclusion In CSA patients PAPP-A levels correlate with age, male gender, hypertension, and CAD extent. In the present study, PAPP-A was an independent predictor for the presence and extent of CAD.