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Circulating pregnancy-associated plasma protein a predicts outcome in patients with acute coronary syndrome but no troponin I elevation.
Circulation. 2003 Oct 21; 108(16):1924-6.Circ

Abstract

BACKGROUND

Risk stratification in troponin (cTn)-negative acute coronary syndrome (ACS) remains a clinical challenge. We investigated the predictive value of circulating pregnancy-associated plasma protein A (PAPP-A), a novel marker of atherosclerotic plaque activity, in these patients.

METHODS AND RESULTS

Two hundred consecutive hospitalized ACS patients were included, of whom 136 (69 men and 67 women; mean+/-SD age, 66+/-16 years) remained cTnI-negative for up to 24 hours. PAPP-A was measured at admission, 6 to 12 hours, and 24 hours. During 6-month follow-up, 26 (19.1%) of the cTnI-negative patients reached a primary end point (cardiovascular death, myocardial infarction, or revascularization). At a cutoff level of 2.9 mIU/L, elevated PAPP-A was an independent predictor of adverse outcome (adjusted risk ratio [RR], 4.6; 95% confidence interval, 1.8 to 11.8; P=0.002). Another independent predictor was admission CRP >2.0 mg/L (RR, 2.6; P=0.03).

CONCLUSIONS

Measurement of plasma PAPP-A, a zinc-binding matrix metalloproteinase, is a strong independent predictor of ischemic cardiac events and need of revascularization in patients who present with suspected myocardial infarction but remain troponin negative.

Authors+Show Affiliations

Department of Medicine, University and Turku University Central Hospital, POB 52, FIN-20520 Turku, Finland. juha.lund@tyks.fiNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

14530192

Citation

Lund, Juha, et al. "Circulating Pregnancy-associated Plasma Protein a Predicts Outcome in Patients With Acute Coronary Syndrome but No Troponin I Elevation." Circulation, vol. 108, no. 16, 2003, pp. 1924-6.
Lund J, Qin QP, Ilva T, et al. Circulating pregnancy-associated plasma protein a predicts outcome in patients with acute coronary syndrome but no troponin I elevation. Circulation. 2003;108(16):1924-6.
Lund, J., Qin, Q. P., Ilva, T., Pettersson, K., Voipio-Pulkki, L. M., Porela, P., & Pulkki, K. (2003). Circulating pregnancy-associated plasma protein a predicts outcome in patients with acute coronary syndrome but no troponin I elevation. Circulation, 108(16), 1924-6.
Lund J, et al. Circulating Pregnancy-associated Plasma Protein a Predicts Outcome in Patients With Acute Coronary Syndrome but No Troponin I Elevation. Circulation. 2003 Oct 21;108(16):1924-6. PubMed PMID: 14530192.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Circulating pregnancy-associated plasma protein a predicts outcome in patients with acute coronary syndrome but no troponin I elevation. AU - Lund,Juha, AU - Qin,Qiu-Ping, AU - Ilva,Tuomo, AU - Pettersson,Kim, AU - Voipio-Pulkki,Liisa-Maria, AU - Porela,Pekka, AU - Pulkki,Kari, Y1 - 2003/10/06/ PY - 2003/10/8/pubmed PY - 2003/10/25/medline PY - 2003/10/8/entrez SP - 1924 EP - 6 JF - Circulation JO - Circulation VL - 108 IS - 16 N2 - BACKGROUND: Risk stratification in troponin (cTn)-negative acute coronary syndrome (ACS) remains a clinical challenge. We investigated the predictive value of circulating pregnancy-associated plasma protein A (PAPP-A), a novel marker of atherosclerotic plaque activity, in these patients. METHODS AND RESULTS: Two hundred consecutive hospitalized ACS patients were included, of whom 136 (69 men and 67 women; mean+/-SD age, 66+/-16 years) remained cTnI-negative for up to 24 hours. PAPP-A was measured at admission, 6 to 12 hours, and 24 hours. During 6-month follow-up, 26 (19.1%) of the cTnI-negative patients reached a primary end point (cardiovascular death, myocardial infarction, or revascularization). At a cutoff level of 2.9 mIU/L, elevated PAPP-A was an independent predictor of adverse outcome (adjusted risk ratio [RR], 4.6; 95% confidence interval, 1.8 to 11.8; P=0.002). Another independent predictor was admission CRP >2.0 mg/L (RR, 2.6; P=0.03). CONCLUSIONS: Measurement of plasma PAPP-A, a zinc-binding matrix metalloproteinase, is a strong independent predictor of ischemic cardiac events and need of revascularization in patients who present with suspected myocardial infarction but remain troponin negative. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/14530192/Circulating_pregnancy_associated_plasma_protein_a_predicts_outcome_in_patients_with_acute_coronary_syndrome_but_no_troponin_I_elevation_ L2 - https://www.ahajournals.org/doi/10.1161/01.CIR.0000096054.18485.07?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -