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Usefulness of pregnancy-associated plasma protein A in patients with acute coronary syndrome.
Am J Cardiol. 2009 Dec 01; 104(11):1465-71.AJ

Abstract

To investigate whether pregnancy-associated plasma protein-A (PAPP-A) is a prognostic marker in patients admitted with high-risk acute coronary syndrome. In patients admitted with high-risk non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and ST-segment elevation myocardial infarction (STEMI), risk stratification is primarily determined by the markers of myocardial necrosis and known demographic risk profiles. However, it has recently been proposed that the presence and extent of vulnerable plaques might influence the prognosis significantly. A marker for the vulnerable plaque could identify patients at high risk who would potentially benefit from intensive treatment and surveillance. Two populations of consecutive patients admitted with high-risk NSTE-ACS (n = 123) and STEMI (n = 314) were evaluated with serial measurements of PAPP-A. The incidence of mortality and nonfatal myocardial infarction was prospectively registered for 2.66 to 3.47 years. In the patients with high-risk NSTE-ACS, PAPP-A was related to the risk of nonfatal myocardial infarction (p = 0.02) and death (p = 0.03). This result was consistent on multivariate analysis of the combination of mortality or nonfatal myocardial infarction (odds ratio 2.65, 95% confidence interval 1.40 to 5.03) but not for mortality alone (p = NS). In patients with STEMI, PAPP-A was related to the risk of death (p = 0.01) but not the composite outcome of myocardial infarction and death. This was also true after adjustment for other univariate predictors of death (odds ratio 2.19, 95% confidence interval 1.16 to 4.16). In conclusion, PAPP-A seems to be valuable in predicting the outcomes of patients admitted with high-risk NSTE-ACS or STEMI.

Authors+Show Affiliations

Department of Cardiology, Hillerod Hospital, Hillerod, Denmark. kasper.iversen@dadlnet.dkNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

19932776

Citation

Iversen, Kasper K., et al. "Usefulness of Pregnancy-associated Plasma Protein a in Patients With Acute Coronary Syndrome." The American Journal of Cardiology, vol. 104, no. 11, 2009, pp. 1465-71.
Iversen KK, Dalsgaard M, Teisner AS, et al. Usefulness of pregnancy-associated plasma protein A in patients with acute coronary syndrome. Am J Cardiol. 2009;104(11):1465-71.
Iversen, K. K., Dalsgaard, M., Teisner, A. S., Schoos, M., Teisner, B., Nielsen, H., Clemmensen, P., & Grande, P. (2009). Usefulness of pregnancy-associated plasma protein A in patients with acute coronary syndrome. The American Journal of Cardiology, 104(11), 1465-71. https://doi.org/10.1016/j.amjcard.2009.07.017
Iversen KK, et al. Usefulness of Pregnancy-associated Plasma Protein a in Patients With Acute Coronary Syndrome. Am J Cardiol. 2009 Dec 1;104(11):1465-71. PubMed PMID: 19932776.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Usefulness of pregnancy-associated plasma protein A in patients with acute coronary syndrome. AU - Iversen,Kasper K, AU - Dalsgaard,Morten, AU - Teisner,Ane S, AU - Schoos,Mikkel, AU - Teisner,Borge, AU - Nielsen,Henrik, AU - Clemmensen,Peter, AU - Grande,Peer, PY - 2009/05/12/received PY - 2009/07/02/revised PY - 2009/07/02/accepted PY - 2009/11/26/entrez PY - 2009/11/26/pubmed PY - 2010/2/2/medline SP - 1465 EP - 71 JF - The American journal of cardiology JO - Am J Cardiol VL - 104 IS - 11 N2 - To investigate whether pregnancy-associated plasma protein-A (PAPP-A) is a prognostic marker in patients admitted with high-risk acute coronary syndrome. In patients admitted with high-risk non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and ST-segment elevation myocardial infarction (STEMI), risk stratification is primarily determined by the markers of myocardial necrosis and known demographic risk profiles. However, it has recently been proposed that the presence and extent of vulnerable plaques might influence the prognosis significantly. A marker for the vulnerable plaque could identify patients at high risk who would potentially benefit from intensive treatment and surveillance. Two populations of consecutive patients admitted with high-risk NSTE-ACS (n = 123) and STEMI (n = 314) were evaluated with serial measurements of PAPP-A. The incidence of mortality and nonfatal myocardial infarction was prospectively registered for 2.66 to 3.47 years. In the patients with high-risk NSTE-ACS, PAPP-A was related to the risk of nonfatal myocardial infarction (p = 0.02) and death (p = 0.03). This result was consistent on multivariate analysis of the combination of mortality or nonfatal myocardial infarction (odds ratio 2.65, 95% confidence interval 1.40 to 5.03) but not for mortality alone (p = NS). In patients with STEMI, PAPP-A was related to the risk of death (p = 0.01) but not the composite outcome of myocardial infarction and death. This was also true after adjustment for other univariate predictors of death (odds ratio 2.19, 95% confidence interval 1.16 to 4.16). In conclusion, PAPP-A seems to be valuable in predicting the outcomes of patients admitted with high-risk NSTE-ACS or STEMI. SN - 1879-1913 UR - https://www.unboundmedicine.com/medline/citation/19932776/Usefulness_of_pregnancy_associated_plasma_protein_A_in_patients_with_acute_coronary_syndrome_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(09)01354-X DB - PRIME DP - Unbound Medicine ER -