Release patterns of pregnancy associated plasma protein A (PAPP-A) in patients with acute coronary syndromes.
OBJECTIVE
Pregnancy associated plasma protein A (PAPP-A) has recently been shown to be associated with acute coronary syndromes (ACS). The goal of this study was to investigate its release patterns in patients with ACS.


METHODS
PAPP-A concentrations in plasma samples serially collected after admissions from 15 patients with ACS were measured. The levels of PAPP-A were compared with a reference range determined from 80 normal subjects. The associations between PAPP-A and myoglobin (Mb), C-reactive protein (CRP), fatty-acid-binding protein (FABP) and creatine kinase MB (CK-MB) were determined.


RESULTS
Various release patterns were observed with 2-10-fold changes of PAPP-A in the different patients. Increases in PAPP-A levels above the reference range could appear early at 2 h or late at 30 h after onset of chest pain. Only in 4 of the 15 cases were significantly elevated PAPP-A levels detected before 6 h after onset. Elevations early after admission showed rapid decline whereas later elevations were more persistent. No associations between PAPP-A and Mb, CRP, FABP and CK-MB were found. However, a weak but significant association to cardiac troponin I (cTn I) was found.


CONCLUSIONS
PAPP-A is an additional marker for ACS, but does not seem to be a useful early marker for acute myocardial infarction (AMI). The possible clinical utility of PAPP-A calls for extensive studies of chest pain patients using serial sampling combined with short- and long-term outcome studies.
Qin
Qiu-Ping
QP
Department of Biotechnology, University of Turku, Tykistökatu 6, FI-20520 Turku, Finland. qiqin@utu.fi
Laitinen
Päivi
P
Majamaa-Voltti
Kirsi
K
Eriksson
Susann
S
Kumpula
Eeva-Katri
EK
Pettersson
Kim
K
D000368:Aged; D000787:Angina Pectoris / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D003196:Computer Graphics; D003402:Creatine Kinase / Q000097:blood; D052279:Creatine Kinase, MB Form; D005260:Female; D015200:Fluoroimmunoassay; D006801:Humans; D007527:Isoenzymes / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood*; D009211:Myoglobin / Q000097:blood; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis*; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D013577:Syndrome; D019210:Troponin I / Q000097:blood
D015415:Biomarkers; D007527:Isoenzymes; D009211:Myoglobin; D019210:Troponin I; D002097:C-Reactive Protein; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form; D011266:Pregnancy-Associated Plasma Protein-A