Myocardial and Peripheral Ischemia Causes an Increase in Circulating Pregnancy-Associated Plasma Protein-A in Non-atherosclerotic, Non-heparinized Pigs

J Cardiovasc Transl Res. 2015 Dec;8(9):528-35. doi: 10.1007/s12265-015-9656-y. Epub 2015 Oct 6.

Abstract

The usefulness of circulating pregnancy-associated plasma protein-A (PAPP-A) as a biomarker for acute coronary syndrome (ACS) is widely debated. We used the pig as a model to assess PAPP-A dynamics in the setting of myocardial ischemia. Induction of myocardial ischemia by ligation of the left anterior descending (LAD) coronary artery caused a systemic rise in PAPP-A. However, the ischemic myocardium was excluded as the source of PAPP-A. Interestingly, induction of ischemia in peripheral tissues by ligation of the left femoral artery caused a systemic rise in PAPP-A originating from the left hind limb. This is the first study to demonstrate PAPP-A elevations in the absence of atherosclerosis or heparin during myocardial ischemia. Our findings thus add to the current discussion of the usefulness of PAPP-A as a biomarker for ACS.

Keywords: Acute coronary syndrome; Biomarker; Ischemia; Myocardium; Pregnancy-associated plasma protein-A; Reperfusion.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analysis of Variance
  • Animals
  • Atherosclerosis
  • Biomarkers / blood
  • Biopsy, Needle
  • Coronary Artery Disease / blood*
  • Coronary Artery Disease / pathology
  • Disease Models, Animal
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Heparin
  • Humans
  • Immunohistochemistry
  • Myocardial Ischemia / blood*
  • Myocardial Ischemia / pathology
  • Peripheral Arterial Disease / blood*
  • Peripheral Arterial Disease / physiopathology
  • Pregnancy
  • Pregnancy, Animal*
  • Pregnancy-Associated Plasma Protein-A / metabolism*
  • Random Allocation
  • Risk Assessment
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Swine

Substances

  • Biomarkers
  • Heparin
  • Pregnancy-Associated Plasma Protein-A