Pregnancy-associated Plasma Protein A
PAPPAproteinPAPP-A is a metalloproteinase elevated in atherosclerotic plaques that degrades extracellular matrix, promoting cap rupture and thrombosis.
Pathway placement
Cascade stepFibrous-cap degradation & rupture
Confidencehigh
RationalePAPP-A is a matrix metalloproteinase; marker of fibrous-cap degradation and plaque destabilization.
Also acts inVascular inflammation
Druggability
DruggableYes
Known drugs / candidates0
Small-molecule tractableNo
Antibody tractableYes
EnsemblENSG00000182752
Type I vs Type II discrimination
ScoresLow-confidence (proxy)
R — rupture / Type-I56
C — confounder / Type-II68
A — assay feasibility68
E — evidence strength27
T1DI (composite)8
Specificity differential (R−C)-11.2
Confounder panel (Type-II drivers)
No confounder evidence retrieved.
Tier: light (literature co-occurrence proxy — lower confidence). See the discrimination table for all markers.
Assay & specimen
Validated clinical assay
Specimen
Serum or plasma
Collection tube
Serum separator (gold/red-top, SST) · K2/K3-EDTA (lavender-top)
Method / principle
Sandwich immunoassay
Reagent / substrate
Anti-PAPP-A antibody pair
Platform
Automated / ELISA
Turnaround · availability
Send-out · Clinical (obstetric)/research
Human genetic evidence
0.025
Open Targets association (STEMI)
Literature evidence(11)
- Synopsis of Biomarkers of Atheromatous Plaque Formation, Rupture and Thrombosis in the Diagnosis of Acute Coronary Syndromes.Current cardiology reviews · 2022 · PMID 35410616 · doi
- Pregnancy associated plasma protein-A as a prognostic biomarker of all-cause mortality and cardiovascular events in patients presenting with chest pain: a systematic review.Biomarkers : biochemical indicators of exposure, response, and susceptibility to chemicals · 2017 · PMID 29144175 · doi
- Long-term prognostic utility of PAPP-A and calprotectin in suspected acute coronary syndrome.Scandinavian cardiovascular journal : SCJ · 2013 · PMID 23406538 · doi
- Elevated PAPP-A sets alarm bells ringing in patients with cardiac chest pain.Expert review of cardiovascular therapy · 2013 · PMID 24325177 · doi
- Markers of plaque instability in the early diagnosis and risk stratification of acute myocardial infarction.Clinical chemistry · 2011 · PMID 22057876 · doi
- Biomarkers in acute myocardial infarction.BMC medicine · 2010 · PMID 20529285 · doi
- Pregnancy associated plasma protein-A (PAPP-A) is not a marker of the vulnerable atherosclerotic plaque.Clinical biochemistry · 2010 · PMID 21185276 · doi
- Usefulness of pregnancy-associated plasma protein A in patients with acute coronary syndrome.The American journal of cardiology · 2009 · PMID 19932776 · doi
- [Inflammation, atherosclerosis and cardiovascular disease risk: PAPP-A, Lp-PLA2 and cystatin C. New insights or redundant information?].Revista espanola de cardiologia · 2006 · PMID 16712749
- The potential role of antiplatelet agents in modulating inflammatory markers in atherothrombosis.Journal of thrombosis and haemostasis : JTH · 2006 · PMID 16961584 · doi
- [Acute coronary syndrome and inflammation. Biomarkers for diagnostics and risk stratification].Herz · 2004 · PMID 15599673 · doi