title: Effect of routine heparins treatment in acute coronary syndrome on serum pregnancy-associated plasma protein a concentration.
abstract: BACKGROUND
  Pregnancy-associated plasma protein A (PAPP-A) has been suggested as a useful marker of acute coronary syndrome (ACS). Serum PAPP-A concentrations are affected by unfractionated heparin (UFH) in ACS population, and we tried to investigate the time profile of effects of routine heparins treatment on serum PAPP-A concentrations in ACS population thoroughly and give advice to sample collection of related study.
  
  
  METHODS
  Twenty cases were involved in this study: ten patients with acute myocardial infarction received subcutaneous low molecular weight heparin (LMWH) twice a day (group A), and the other ten percutaneous coronary intervention patients with stenting received intravenous UFH (group B). Samples were collected before and after heparin administration and serum PAPP-A concentrations were analyzed in these samples.
  
  
  RESULTS
  Serum PAPP-A concentration increased in both group A and B. In group A, PAPP-A concentration elevated gradually (14.5 to 29.4 mIU/L, P<0.05) throughout the observation period and normalized at 48h after drug discontinuation. In group B, there was a rapid and intense increase after intravenous heparin injection (13.1 to 49.3 mIU/L, P<0.05), and a new PAPP-A peak was induced by additional heparin administration.
  
  
  CONCLUSIONS
  Heparins-induced increase in serum PAPP-A concentration lasted until 48h after drug use was discontinued. We recommend that samples from these patients for PAPP-A measurement should be collected at least 48h after the last administration if its not available before the administration of heparins.
authors.affiliation: Department of Cardiology, Weifang People's Hospital, Weifang, Shandong, 261041, P.R.China. guodongwang101@126.com
authors.forename: Guodong
authors.initials: G
authors.lastname: Wang
authors.forename: Aiyuan
authors.initials: A
authors.lastname: Zhang
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Han
authors.forename: Jungang
authors.initials: J
authors.lastname: Zhang
authors.forename: Guangfang
authors.initials: G
authors.lastname: Zhang
authors.forename: Liping
authors.initials: L
authors.lastname: Sun
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D015415:Biomarkers / Q000097:blood*; D005260:Female; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism*; D011379:Prognosis; D013997:Time Factors
chemical_list: D000925:Anticoagulants; D015415:Biomarkers; D006493:Heparin; D011266:Pregnancy-Associated Plasma Protein-A; C579283:PAPPA protein, human
keywords: acute coronary syndrome; heparin; low-molecular-weight; pregnancy-associated plasma protein A