title: Pregnancy-associated plasma protein-A, a marker for outcome in patients suspected for acute coronary syndrome.
abstract: OBJECTIVE
  To examine if pregnancy-associated plasma protein-A (PAPP-A) in patients with chest pain, could identify patients at risk for death or myocardial infarction.
  
  
  METHODS
  Patients admitted with chest pain and both normal ECG and normal biomarkers were evaluated by serial measurement of PAPP-A. Main outcome measures were mortality and non-fatal myocardial infarction.
  
  
  RESULTS
  Median age of patients included (415) was 67years and 43% were women. The risk of death or non-fatal myocardial infarction after 3 months was 15% in the highest quartile of circulating PAPP-A compared with 3% in the lowest quartile (relative risk 3.7, p<0.01). Corresponding numbers after 1 year were 24% and 10% (relative risk 2.4, p=0.01).
  
  
  CONCLUSIONS
  In patients admitted with chest pain and both normal ECG and normal biomarkers PAPP-A seems to be valuable for predicting patients at high risk of death or non-fatal myocardial infarction.
authors.affiliation: Department of Cardiology, Hillerod Hospital, Hillerod, Denmark. kasper.iversen@dadlnet.dk
authors.forename: Kasper K
authors.initials: KK
authors.lastname: Iversen
authors.forename: Morten
authors.initials: M
authors.lastname: Dalsgaard
authors.forename: Ane S
authors.initials: AS
authors.lastname: Teisner
authors.forename: Mikkel
authors.initials: M
authors.lastname: Schoos
authors.forename: Borge
authors.initials: B
authors.lastname: Teisner
authors.forename: Henrik
authors.initials: H
authors.lastname: Nielsen
authors.forename: Peer
authors.initials: P
authors.lastname: Grande
authors.forename: Peter
authors.initials: P
authors.lastname: Clemmensen
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002637:Chest Pain / Q000097:blood; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis*; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers; D011266:Pregnancy-Associated Plasma Protein-A