Pregnancy-associated plasma protein predicts outcomes of percutaneous coronary intervention in patients with non-ST-elevation acute coronary syndrome.
OBJECTIVE
Pregnancy-associated plasma protein A (PAPP-A) may play an important role in the development of acute coronary syndrome. This study aimed to investigate the relationship between the levels of circulating PAPP-A and the mid-term outcomes of percutaneous coronary intervention (PCI) in patients with non-ST-elevation acute coronary syndrome.


METHODS
The circulating PAPP-A levels and high-sensitivity C-reactive protein before PCI were measured in 129 patients with single coronary artery stenosis. The end point of clinical follow-up was cardiac death, nonfatal myocardial infarction, target vessel revascularization, and rehospitalization for angina.


RESULTS
During the follow-up of an average of 20.3 ± 5.2 months, a cardiac event was recorded in 25 patients (19.4%). The levels of PAPP-A (29.85 ± 19.51 mIu/L vs 20.47 ± 14.33 mIu/L, P = .007) and high-sensitivity C-reactive protein (5.63 ± 2.13 mg/L vs 4.11 ± 1.28 mg/L, P = .014) in patients with cardiac events were higher than in those without cardiac events. PAPP-A ≥ 11.33 mIu/L has a strong predictive value for a combined end point (risk ratio = 4.1; 95% confidence interval, 1.0-16.2; P = .037). Patients with lower PAPP-A levels (<11.33 mIu/L) had higher event-free survivals than patients with higher PAPP-A levels (log rank = 9.334, P = .025).


CONCLUSIONS
Circulating PAPP-A levels predict the mid-term outcomes of PCI in patients with non-ST-elevation acute coronary syndrome and single-vessel stenosis.
Mei
Wei-Yi
WY
Department of Cardiology, Huangpu Division of The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, PR China.
Du
Zhi-Min
ZM
Zhao
Qiang
Q
Hu
Cheng-Heng
CH
Li
Yi
Y
Luo
Chu-Fan
CF
Wu
Gui-Fu
GF
Chen
Guo-Wei
GW
Wang
Le-Xin
LX
D054058:Acute Coronary Syndrome / Q000097:blood* / Q000401:mortality / Q000628:therapy*; D000328:Adult; D000368:Aged; D000789:Angina, Unstable / Q000097:blood / Q000401:mortality / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary; D002681:China; D016001:Confidence Intervals; D023921:Coronary Stenosis / Q000097:blood* / Q000401:mortality / Q000628:therapy*; D003422:Critical Care; D005260:Female; D006801:Humans; D008297:Male; D008432:Mathematical Computing; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000401:mortality / Q000628:therapy; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism*; D011379:Prognosis; D016019:Survival Analysis; D016896:Treatment Outcome
D011266:Pregnancy-Associated Plasma Protein-A