SAA/Cardiovascular Disease Panel Interpretation Guide

Pathway Analysis

These sections summarize biologically relevant immune signaling pathways that may be suggested by patterns observed across the measured analytes. These pathway groupings are derived from known functional relationships between cytokines, chemokines, and growth factors.

Activation of a given pathway is inferred when multiple related markers are elevated in a coordinated manner. These interpretations are intended to provide biological context for the results and should be considered alongside clinical findings and other laboratory data.

Acute Phase Inflammatory Signaling

Back to top

This pathway reflects systemic inflammatory responses mediated by acute phase reactants produced primarily by the liver.

Core Acute Phase Marker

  • SAA (Serum Amyloid A) – A highly sensitive acute phase protein that rises rapidly in response to inflammation, infection, or tissue injury1,2.

Supporting Context

  1. Ye RD, Sun L. Emerging functions of serum amyloid A in inflammation. J Leukoc Biol. Dec 2015;98(6):923-9. doi:10.1189/jlb.3VMR0315-080R
  2. Almusalami EM, Lockett A, Ferro A, Posner J. Serum amyloid A-A potential therapeutic target for hyper-inflammatory syndrome associated with COVID-19. Front Med (Lausanne). 2023;10:1135695. doi:10.3389/fmed.2023.1135695

Endothelial Activation and Vascular Inflammation

Back to top

This pathway reflects activation of the vascular endothelium, often in response to inflammatory stimuli, infection, or vascular injury. Endothelial activation promotes leukocyte adhesion, vascular permeability, and inflammatory signaling.

Core Endothelial Activation Markers

  • sICAM-1 (Soluble Intercellular Adhesion Molecule-1) – Reflects endothelial activation and facilitates leukocyte adhesion and transmigration1.
  • sVCAM-1 (Soluble Vascular Cell Adhesion Molecule-1) – Mediates adhesion of immune cells to the endothelium and is associated with inflammatory vascular responses2.

Supporting Context

  1. Lawson C, Wolf S. ICAM-1 signaling in endothelial cells. Pharmacol Rep. 2009;61(1):22-32. doi:10.1016/s1734-1140(09)70004-0
  2. Troncoso MF, Ortiz-Quintero J, Garrido-Moreno V, et al. VCAM-1 as a predictor biomarker in cardiovascular disease. Biochim Biophys Acta Mol Basis Dis. Sep 01 2021;1867(9):166170. doi:10.1016/j.bbadis.2021.166170

Coagulation and Thrombotic Pathway Activity

Back to top

This pathway reflects processes involved in coagulation, fibrinolysis, and platelet activation. Elevations may indicate increased thrombotic activity, endothelial injury, or dysregulation of clotting pathways.

Core Coagulation and Platelet Markers

  • ADAMTS13 – Regulates von Willebrand factor activity and plays a key role in maintaining normal coagulation balance1.
  • D-Dimer – A fibrin degradation product that reflects active clot formation and breakdown2.
  • sP-Selectin – Marker of platelet activation and endothelial interaction, contributing to thrombus formation3.

Supporting Context

  1. DeYoung V, Singh K, Kretz CA. Mechanisms of ADAMTS13 regulation. J Thromb Haemost. Dec 2022;20(12):2722-2732. doi:10.1111/jth.15873
  2. Lippi G, Mullier F, Favaloro EJ. D-dimer: old dogmas, new (COVID-19) tricks. Clin Chem Lab Med. Apr 25 2023;61(5):841-850. doi:10.1515/cclm-2022-0633
  3. André P. P-selectin in haemostasis. Br J Haematol. Aug 2004;126(3):298-306. doi:10.1111/j.1365-2141.2004.05032.x