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Pregnancy associated plasma protein A, a novel, quick, and sensitive marker in ST-elevation myocardial infarction.
Am J Cardiol. 2008 May 15; 101(10):1389-94.AJ

Abstract

Traditional biomarkers in acute coronary syndromes reflect myocardial necrosis but not the underlying arteriosclerotic disease. Pregnancy-associated plasma protein A (PAPP-A) is a new biomarker in acute coronary syndromes that detects vulnerable plaques in arteriosclerotic disease and identifies acute coronary syndromes earlier than traditionally used biomarkers. Information regarding circulating PAPP-A levels in patients with ST elevation myocardial infarctions (STEMIs) is limited and contradictory. The aim of the present study was to describe the presence and time-related pattern of circulating PAPP-A levels in patients with STEMIs. Consecutive patients (n = 354) referred for primary percutaneous intervention because of STEMI were included in the study. Blood samples for the analysis of PAPP-A, creatine kinase-MB (CKMB), and troponin T were drawn at admission and every 6 to 8 hours until biomarkers of myocardial necrosis were consistently decreasing. PAPP-A was measured using a newly developed sandwich enzyme-linked immunosorbent assay technique based on 2 monoclonal antibodies. In total, 1,091 PAPP-A, 1,049 troponin T, and 1,016 CKMB samples were analyzed. Mean PAPP-A values at admission were significantly higher in patients with STEMIs than in those with non-ST elevation myocardial infarctions or unstable angina pectoris (27.6 vs 12.2 mIU/L, p <0.01). In samples drawn <2 hours after admission, the sensitivity of PAPP-A was superior (93%) to that of CKMB (60%) and troponin T (61%). In conclusion, PAPP-A levels are elevated in >90% of patients presenting with STEMIs if measured <6 hours after the onset of symptoms or <2 hours of primary percutaneous coronary intervention. In the early stages of STEMI, PAPP-A seems to be a more sensitive marker of myocardial infarction than CKMB and troponin T.

Authors+Show Affiliations

The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. kasper.iversen@dadlnet.dkNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18471447

Citation

Iversen, Kasper K., et al. "Pregnancy Associated Plasma Protein A, a Novel, Quick, and Sensitive Marker in ST-elevation Myocardial Infarction." The American Journal of Cardiology, vol. 101, no. 10, 2008, pp. 1389-94.
Iversen KK, Teisner AS, Teisner B, et al. Pregnancy associated plasma protein A, a novel, quick, and sensitive marker in ST-elevation myocardial infarction. Am J Cardiol. 2008;101(10):1389-94.
Iversen, K. K., Teisner, A. S., Teisner, B., Kliem, A., Thanning, P., Grande, P., & Clemmensen, P. (2008). Pregnancy associated plasma protein A, a novel, quick, and sensitive marker in ST-elevation myocardial infarction. The American Journal of Cardiology, 101(10), 1389-94. https://doi.org/10.1016/j.amjcard.2008.01.015
Iversen KK, et al. Pregnancy Associated Plasma Protein A, a Novel, Quick, and Sensitive Marker in ST-elevation Myocardial Infarction. Am J Cardiol. 2008 May 15;101(10):1389-94. PubMed PMID: 18471447.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pregnancy associated plasma protein A, a novel, quick, and sensitive marker in ST-elevation myocardial infarction. AU - Iversen,Kasper K, AU - Teisner,Ane S, AU - Teisner,Borge, AU - Kliem,Anette, AU - Thanning,Pia, AU - Grande,Peer, AU - Clemmensen,Peter, Y1 - 2008/03/17/ PY - 2007/10/06/received PY - 2008/01/04/revised PY - 2008/01/04/accepted PY - 2008/5/13/pubmed PY - 2008/6/25/medline PY - 2008/5/13/entrez SP - 1389 EP - 94 JF - The American journal of cardiology JO - Am J Cardiol VL - 101 IS - 10 N2 - Traditional biomarkers in acute coronary syndromes reflect myocardial necrosis but not the underlying arteriosclerotic disease. Pregnancy-associated plasma protein A (PAPP-A) is a new biomarker in acute coronary syndromes that detects vulnerable plaques in arteriosclerotic disease and identifies acute coronary syndromes earlier than traditionally used biomarkers. Information regarding circulating PAPP-A levels in patients with ST elevation myocardial infarctions (STEMIs) is limited and contradictory. The aim of the present study was to describe the presence and time-related pattern of circulating PAPP-A levels in patients with STEMIs. Consecutive patients (n = 354) referred for primary percutaneous intervention because of STEMI were included in the study. Blood samples for the analysis of PAPP-A, creatine kinase-MB (CKMB), and troponin T were drawn at admission and every 6 to 8 hours until biomarkers of myocardial necrosis were consistently decreasing. PAPP-A was measured using a newly developed sandwich enzyme-linked immunosorbent assay technique based on 2 monoclonal antibodies. In total, 1,091 PAPP-A, 1,049 troponin T, and 1,016 CKMB samples were analyzed. Mean PAPP-A values at admission were significantly higher in patients with STEMIs than in those with non-ST elevation myocardial infarctions or unstable angina pectoris (27.6 vs 12.2 mIU/L, p <0.01). In samples drawn <2 hours after admission, the sensitivity of PAPP-A was superior (93%) to that of CKMB (60%) and troponin T (61%). In conclusion, PAPP-A levels are elevated in >90% of patients presenting with STEMIs if measured <6 hours after the onset of symptoms or <2 hours of primary percutaneous coronary intervention. In the early stages of STEMI, PAPP-A seems to be a more sensitive marker of myocardial infarction than CKMB and troponin T. SN - 0002-9149 UR - https://www.unboundmedicine.com/medline/citation/18471447/Pregnancy_associated_plasma_protein_A_a_novel_quick_and_sensitive_marker_in_ST_elevation_myocardial_infarction_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(08)00142-2 DB - PRIME DP - Unbound Medicine ER -