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 16307 men (age, 35-59 years), 446 cases had a history of CHD or prominent Q:QS waves on electrocardiogram. For each case, two matched controls were 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=0.26), and body mass index (r=0.13) (P<0.001). Serum CRP is a better marker for CHD than SAA, which showed discriminative power 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.
Delanghe
Joris R
JR
Department of Clinical Chemistry, Microbiology and Immunology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium. joris.delanghe@rug.ac.be
Langlois
Michel R
MR
De Bacquer
Dirk
D
Mak
Rudolf
R
Capel
Paul
P
Van Renterghem
Lieve
L
De Backer
Guy
G
D000209:Acute-Phase Proteins / Q000032:analysis*; D000328:Adult; D000907:Antibodies, Bacterial / Q000032:analysis; D000914:Antibodies, Viral / Q000032:analysis; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D016993:Chlamydophila pneumoniae / Q000276:immunology; D003327:Coronary Disease / Q000097:blood* / Q000382:microbiology; D003587:Cytomegalovirus / Q000276:immunology; D005340:Fibrinogen / Q000032:analysis; D006242:Haptoglobins / Q000032:analysis; D016480:Helicobacter pylori / Q000276:immunology; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D000685:Serum Amyloid A Protein / Q000032:analysis*
D000209:Acute-Phase Proteins; D000907:Antibodies, Bacterial; D000914:Antibodies, Viral; D006242:Haptoglobins; D000685:Serum Amyloid A Protein; D005340:Fibrinogen; D002097:C-Reactive Protein