title: Plaque characteristics and serum pregnancy-associated plasma protein A levels predict the no-reflow phenomenon after percutaneous coronary intervention.
abstract: OBJECTIVE
  To investigate the relationship between serum plasma pregnancy-associated plasma protein A (PAPP-A) and coronary plaque characteristics, and their prognostic value for coronary no-reflow after percutaneous coronary intervention (PCI).
  
  
  METHODS
  Patients with unstable angina undergoing PCI were divided into a normal reflow group and a no-reflow group after stent deployment. Coronary blood flow was measured angiographically; plaque components were detected by virtual histology intravascular ultrasound. Serum PAPP-A and high-sensitivity C-reactive protein (hsCRP) were measured before PCI. Cardiac troponin T (cTnT) was measured before and 24 h after PCI.
  
  
  RESULTS
  A total of 166 patients with unstable angina undergoing PCI were included: normal reflow group (n = 145) and no-reflow group (n = 21), after stent deployment. Baseline coronary blood flow was similar in the two groups. The no-reflow group had plaques with less-fibrotic tissue and a larger necrotic core, more thin-cap fibroatheromas and plaque ruptures, and higher serum PAPP-A, hsCRP and post-PCI cTnT levels than the normal reflow group. Serum PAPP-A was correlated negatively with plaque fibrotic area and positively with necrotic core area.
  
  
  CONCLUSIONS
  High serum PAPP-A and plaque lesions with a large necrotic core are associated with the no-reflow phenomenon after PCI, in patients with unstable angina.
authors.affiliation: Department of Cardiology, First Affiliated Hospital, Zhengzhou University, Zhengzhou, China.
authors.forename: Xiao-Yan
authors.initials: XY
authors.lastname: Zhao
authors.forename: Xiao-Fang
authors.initials: XF
authors.lastname: Wang
authors.forename: Ling
authors.initials: L
authors.lastname: Li
authors.forename: Jin-Ying
authors.initials: JY
authors.lastname: Zhang
authors.forename: You-You
authors.initials: YY
authors.lastname: Du
authors.forename: Hai-Mu
authors.initials: HM
authors.lastname: Yao
mesh_terms: D000789:Angina, Unstable / Q000601:surgery; D002097:C-Reactive Protein / Q000378:metabolism; D017023:Coronary Angiography; D005260:Female; D005355:Fibrosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D054318:No-Reflow Phenomenon / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology*; D062645:Percutaneous Coronary Intervention; D058226:Plaque, Atherosclerotic / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism*; D020107:Troponin T / Q000378:metabolism
chemical_list: D020107:Troponin T; D002097:C-Reactive Protein; D011266:Pregnancy-Associated Plasma Protein-A
keywords: Angina pectoris; intravascular ultrasound; no-reflow phenomenon; pregnancy-associated plasma protein A