Serum Amyloid A as a Predictor of Coronary Artery Disease and Cardiovascular Outcome in Women

Abstract

Background-Serum amyloid-␣ (SAA) is a sensitive marker of an acute inflammatory state. Like high-sensitivity C-reactive protein (hs-CRP), SAA has been linked to atherosclerosis. However, prior studies have yielded inconsistent results, and the independent predictive value of SAA for coronary artery disease (CAD) severity and cardiovascular events remains unclear. Methods and Results-A total of 705 women referred for coronary angiography for suspected myocardial ischemia underwent plasma assays for SAA and hs-CRP, quantitative angiographic assessment, and follow-up evaluation. Cardiovascular events were death, myocardial infarction, congestive heart failure, stroke, and other vascular events. The women's mean age was 58 years (range 21 to 86 years), and 18% were nonwhite. SAA and hs-CRP were associated with a broad range of CAD risk factors. After adjustment for these risk factors, SAA levels were independently but moderately associated with angiographic CAD (Pϭ0.004 to 0.04) and highly predictive of 3-year cardiovascular events (PϽ0.0001). By comparison, hs-CRP was not associated with angiographic CAD (Pϭ0.08 to 0.35) but, like SAA, was strongly and independently predictive of adverse cardiovascular outcome (PϽ0.0001). Conclusions-Our results show a strong independent relationship between SAA and future cardiovascular events, similar to that found for hs-CRP. Although SAA was independently but moderately associated with angiographic CAD, this association was not found for hs-CRP. These results are consistent with the hypothesis that systemic inflammation, manifested by high SAA or hs-CRP levels, may promote atherosclerotic plaque destabilization, in addition to exerting a possible direct effect on atherogenesis.

Expression profiling of 11β-hydroxysteroid dehydrogenase type-1 and glucocorticoid-target genes in subcutaneous and omental human preadipocytes

“…Recently, adipose tissue has been identified as a major production site of serum amyloid A (ASSA; Sjoholm et al 2005), a known risk factor for coronary artery disease (Johnson et al 2004). In this study, we have shown that ASSA is a GC-target gene in OM preadipocytes.…”

Systemic serum amyloid A as a biomarker for exposure to zinc and/or copper-containing metal fumes

“…This moderate acute-phase response may vary to a certain extent for different individuals and may represent an increased health risk in the case of frequent exposure. Furthermore, CRP and SAA are both robust biomarkers that indicate an increased risk for cardiovascular risk, 8,14 and both markers, particularly SAA, may functionally contribute to this type of disease. 15,16 The consideration of these data may be important for the general and individual short-as well as long-term occupational health surveillance of workers working with these metal fumes, which become more common in modern joining technology.…”

Serum high-sensitivity C-reactive protein, amyloid-associated protein and N-terminal proBNP levels do not predict reversible myocardial ischaemia

“…Serum levels of SAA rise with obesity, diabetes and the metabolic syndrome 10,11. Some studies point to a positive correlation between SAA and angiographically proven coronary artery disease, and serum concentration of SAA is reported to be a powerful predictor of cardiovascular events 12,13. It has been shown that patients with a high SAA concentration have more active atherosclerotic disease,14 but the relationship between serum SAA levels and transient myocardial ischaemia during exercise is not known.…”