PAPPA and angina pectoris: Studies in patients with stable angina have proved the superiority of PAPP-A over troponin T and hs-CRP levels.52 Elevated PAPP-A levels in asymptomatic hyperlipidaemic patients were associated with increased echogenicity of carotid atherosclerotic plaques.53 Experimental as well as epidemiological data substantiated the role of PAPP-A in the detection of unstable CAD in patients with normal troponin levels.54,55 This could help in the prompt identification and timely intervention in high-risk populations.