title: [Evaluation on the relationship between pregnancy associated plasma protein-a and intravascular ultrasound detected culprit coronary plaque morphology in patients with unstable angina].
abstract: OBJECTIVE
  To assess the relationship between pregnancy associated plasma protein-A (PAPP-A) and culprit coronary plaque morphology in patients with unstable angina (UA).
  
  
  METHODS
  Sixty-eight UA patients undergoing diagnostic coronary angiography and intravascular ultrasound were included in this study. A sandwich enzyme-linked immunosorbent assay technique was used to assay the circulating PAPP-A. Plaque characteristics of culprit lesion were analyzed for UA patients with various PAPP-A levels.
  
  
  RESULTS
  PAPP-A level was significantly higher in high-risk UA than in non-high-risk UA [(19.9 ± 20.1) mIU/L vs. (6.9 ± 5.7) mIU/L, P = 0.002]. Optimal threshold of PAPP-A to predict high-risk UA was determined as 11.0 mIU/L with a sensitivity of 78.6% and a specificity of 77.5%. Patients with higher PAPP-A level (≥ 11.0 mIU/L) was associated with larger external elastic membrane cross-sectional area, plaque area and more plaque burden compared with patients with lower PAPP-A level (all P < 0.01). Positive remodeling, attenuated plaque and plaque rupture were significantly more often in patients with higher PAPP-A than in patients with lower PAPP-A level (all P < 0.01). PAPP-A ≥ 11.0 mIU/L (OR = 5.921, P = 0.014) and attenuated plaque (OR = 7.541, P = 0.038) were independent risk predictors for high-risk UA.
  
  
  CONCLUSIONS
  PAPP-A was associated with instability of culprit plaque in UA patients. PAPP-A ≥ 11.0 mIU/L and attenuated plaque were independent predictors for high-risk UA.
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
authors.forename: Xiao-fan
authors.initials: XF
authors.lastname: Wu
authors.forename: Yun-dai
authors.initials: YD
authors.lastname: Chen
authors.forename: Shu-zheng
authors.initials: SZ
authors.lastname: Lü
authors.forename: Fang
authors.initials: F
authors.lastname: Ren
authors.forename: Chang-jiang
authors.initials: CJ
authors.lastname: Ge
authors.forename: Ze-Ning
authors.initials: ZN
authors.lastname: Jin
authors.forename: Kai
authors.initials: K
authors.lastname: Tan
authors.forename: Feng
authors.initials: F
authors.lastname: Xu
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000097:blood* / Q000000981:diagnostic imaging*; D003324:Coronary Artery Disease / Q000097:blood / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism*; D018084:Ultrasonography, Interventional
chemical_list: D011266:Pregnancy-Associated Plasma Protein-A