title: Pregnancy associated plasma protein-A (PAPP-A) as an early marker for the diagnosis of acute coronary syndrome.
abstract: OBJECTIVE
  Pregnancy associated plasma protein-A (PAPP-A), a metalloproteinase plays a pivotal role in the pathogenesis of atherosclerosis. Recent studies have reported that elevated levels of PAPP-A, signal the onset of acute coronary syndrome (ACS). We, therefore, proposed to study the analytical competence of PAPP-A in patients admitted to the emergency department with chest pain and finally diagnosed as ACS.
  
  
  RESULTS
  Pregnancy associated plasma protein-A was measured using enzyme-linked immunosorbent assay (ELISA) in 485 patients admitted to emergency care unit, of which 89 patients were diagnosed as Non-cardiac chest pain (NCCP). Elevated levels of PAPP-A were observed in patients diagnosed as ACS on comparison with the controls. Receiver operator characteristic (ROC) curve analysis showed PAPP-A to be a good discriminator between ischaemic and non-ischaemic patients. The area under the curve was found to be 0.904, 95% CI (0.874-0.929) with 90% sensitivity and 85% specificity (P< 0.0001). The cut-off value from the ROC curve was 0.55 μg/mL above which PAPP-A was considered to be positive.
  
  
  CONCLUSIONS
  Pregnancy associated plasma protein-A seems to be a promising biomarker for identification and risk stratification for patients with ACS.
authors.affiliation: Frontier Lifeline Hospital, Chennai, Tamilnadu, India.
authors.forename: Priya
authors.initials: P
authors.lastname: Gururajan
authors.forename: Prema
authors.initials: P
authors.lastname: Gurumurthy
authors.forename: Pradeep
authors.initials: P
authors.lastname: Nayar
authors.forename: G Srinivasa Nageswara
authors.initials: GS
authors.lastname: Rao
authors.forename: R Sai
authors.initials: RS
authors.lastname: Babu
authors.forename: A
authors.initials: A
authors.lastname: Sarasabharati
authors.forename: K M
authors.initials: KM
authors.lastname: Cherian
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood*; D052279:Creatine Kinase, MB Form / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis*; D012372:ROC Curve; D019210:Troponin I / Q000097:blood
chemical_list: D015415:Biomarkers; D019210:Troponin I; D052279:Creatine Kinase, MB Form; D011266:Pregnancy-Associated Plasma Protein-A