title: Pregnancy associated plasma protein-A (PAPP-A) is not a marker of the vulnerable atherosclerotic plaque.
abstract: OBJECTIVE
  To investigate if pregnancy associated plasma protein-A (PAPP-A) was present in the vulnerable plaque, and if not, to find alternative hypothesis for the release of PAPP-A.
  
  
  METHODS
  Vulnerable plaques and control tissues were examined by immunohistochemistry. Volunteers and patients with non-atherosclerotic disease were examined for release of PAPP-A during ischemia and medical treatment. Non-atherosclerotic tissue samples were examined after incubation with heparins.
  
  
  RESULTS
  We were not able to detect PAPP-A in vulnerable plaques. Patients and volunteers experiencing ischemic events without atherosclerotic lesions only had elevated PAPP-A when treated with heparin. When tissue from normal artery wall was incubated with heparin, PAPP-A was eluted. This was not the case for non-arterial tissue samples.
  
  
  CONCLUSIONS
  Elevation of PAPP-A in patients with acute coronary syndromes seems to be caused by heparin induced release of PAPP-A from the arterial wall and not due to excretion from vulnerable plaques.
authors.affiliation: Department of Cardiology, Hillerod Hospital, Hillerod, Denmark. kasper.iversen@dadlnet.dk
authors.forename: Kasper
authors.initials: K
authors.lastname: Iversen
authors.forename: Ane
authors.initials: A
authors.lastname: Teisner
authors.forename: Soren
authors.initials: S
authors.lastname: Dalager
authors.forename: Karen Ege
authors.initials: KE
authors.lastname: Olsen
authors.forename: Charlotte
authors.initials: C
authors.lastname: Floridon
authors.forename: Børge
authors.initials: B
authors.lastname: Teisner
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology; D000368:Aged; D050197:Atherosclerosis / Q000097:blood* / Q000175:diagnosis* / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D003951:Diagnostic Errors; D005189:False Positive Reactions; D005260:Female; D006493:Heparin / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007150:Immunohistochemistry; D007511:Ischemia / Q000097:blood / Q000503:physiopathology; D008297:Male; D009203:Myocardial Infarction / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology; D058226:Plaque, Atherosclerotic / Q000097:blood* / Q000175:diagnosis* / Q000503:physiopathology; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis* / Q000378:metabolism
chemical_list: D015415:Biomarkers; D006493:Heparin; D011266:Pregnancy-Associated Plasma Protein-A