Increased levels of pregnancy-associated plasma protein-A in patients with hypercholesterolemia: the effect of atorvastatin treatment

• Published in: The American heart journal 2003-12, Vol.146 (6), p.1060-1063
• Main Authors: Štulc, Tomáš, Malbohan, Ivan, Malík, Jan, Fialová, Lenka, Soukupová, Jiřina, Češka, Richard
• Format: Article
• Language: English
• Subjects: Anticholesteremic Agents - therapeutic use; Atorvastatin Calcium; Biomarkers - blood; Case-Control Studies; Cholesterol; Drug therapy; Female; Follow-Up Studies; Heart attacks; Heptanoic Acids - therapeutic use; Humans; Hypercholesterolemia - blood; Hypercholesterolemia - drug therapy; Low density lipoprotein; Male; Middle Aged; Muscular system; Pregnancy-Associated Plasma Protein-A - metabolism; Pyrroles - therapeutic use
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/S0002-8703(03)00446-0

Serum levels of pregnancy-associated plasma protein-A (PAPP-A) have recently been linked to plaque instability and are increased in acute coronary syndromes. The relation between PAPP-A levels and coronary risk factors, namely blood lipids, has not been studied to date. We have therefore investigated whether serum PAPP-A levels are increased in asymptomatic hypercholesterolemic subjects and whether PAPP-A levels are influenced by atorvastatin therapy. We examined 27 subjects with isolated hypercholesterolemia free of manifest vascular disease and 29 age-matched healthy control subjects. Patients were examined at baseline and after 10 weeks of atorvastatin treatment (20 mg/d). In untreated hypercholesterolemic subjects, PAPP-A levels were significantly higher than in control subjects (8.02 ± 1.86 mU/L vs 6.50 ± 2.54 mU/L, P = .018). There was no correlation between PAPP-A levels and serum lipid levels. Atorvastatin treatment reduced total and LDL-cholesterol by 31% and 40%, respectively. Despite this profound lipid lowering, there was no significant change in the serum PAPP-A levels. PAPP-A levels are elevated in hypercholesterolemic subjects without clinical signs of atherosclerosis. PAPP-A may therefore not only reflect plaque instability but also serve as a marker of total atherosclerotic burden in asymptomatic subjects with hyperlipidemia. However, PAPP-A levels are not influenced by atorvastatin treatment.