Elvin Zengin1, Christoph Sinning1, Tanja Zeller1, Hans-J Rupprecht2, Renate B Schnabel1, Karl-J Lackner3, Stefan Blankenberg1, Dirk Westermann1, Christoph Bickel4. 1. Department of General & Interventional Cardiology, University Heart Center Hamburg, Martinistr. 52, 20246 Hamburg, Germany. 2. Department of Medicine II, GPR Rüsselsheim, August-Bebel-Straße 59, 65428 Rüsselsheim, Germany. 3. Institute of Clinical Chemistry & Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany. 4. Department of Internal Medicine, Federal Armed Forces Central Hospital, Rübenacher Straße 170, 56072 Koblenz, Germany.
Abstract
BACKGROUND: Pregnancy-associated plasma protein-A (PAPP-A) is discussed as a biomarker representing unstable plaques in coronary artery disease (CAD). METHODS: In this study 927 patients with CAD (534 with stable angina and 393 with acute coronary syndrome [ACS]) and 217 patients without CAD and measured PAPP-A levels were included. Follow-up for a median of 5 years was documented. RESULTS: Rising quartiles of PAPP-A concentration had a higher cardiovascular mortality in the overall cohort of patients with CAD (p = 0.002) and the cohort with ACS (p = 0.01). Patients with suspected ACS below the LOD for troponin I but elevated PAPP-A levels had an increased cardiovascular mortality. A cut-off of 11.4 IU/l identified patients with a higher mortality during follow-up. CONCLUSION: Rising PAPP-A levels are prognostic in patients with CAD. PAPP-A levels were especially predictive in ACS patients with troponin below 10% CV of the 99 th percentile for cardiovascular mortality.
BACKGROUND:Pregnancy-associated plasma protein-A (PAPP-A) is discussed as a biomarker representing unstable plaques in coronary artery disease (CAD). METHODS: In this study 927 patients with CAD (534 with stable angina and 393 with acute coronary syndrome [ACS]) and 217 patients without CAD and measured PAPP-A levels were included. Follow-up for a median of 5 years was documented. RESULTS: Rising quartiles of PAPP-A concentration had a higher cardiovascular mortality in the overall cohort of patients with CAD (p = 0.002) and the cohort with ACS (p = 0.01). Patients with suspected ACS below the LOD for troponin I but elevated PAPP-A levels had an increased cardiovascular mortality. A cut-off of 11.4 IU/l identified patients with a higher mortality during follow-up. CONCLUSION: Rising PAPP-A levels are prognostic in patients with CAD. PAPP-A levels were especially predictive in ACS patients with troponin below 10% CV of the 99 th percentile for cardiovascular mortality.
Authors: H Gutiérrez-Leonard; E Martínez-Lara; A E Fierro-Macías; V M Mena-Burciaga; M D Ronquillo-Sánchez; E Floriano-Sánchez; N Cárdenas-Rodríguez Journal: Ir J Med Sci Date: 2016-10-11 Impact factor: 1.568
Authors: Erik Nilsson; Jens Kastrup; Ahmad Sajadieh; Gorm Boje Jensen; Erik Kjøller; Hans Jørn Kolmos; Jonas Wuopio; Christoph Nowak; Anders Larsson; Janus Christian Jakobsen; Per Winkel; Christian Gluud; Kasper K Iversen; Johan Ärnlöv; Axel C Carlsson Journal: J Clin Med Date: 2020-01-18 Impact factor: 4.241