Prognostic value of circulating pregnancy-associated plasma protein levels in patients with chronic stable angina

Unstable coronary atherosclerotic plaque can be present in patients with chronic stable coronary artery disease (CAD). Our objective was to assess whether measurement of plasma pregnancy-associated plasma protein (PAPP-A) level, a reflection of plaque instability, in patients with chronic stable CAD...

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Bibliographic Details
Published in:European heart journal 2006-07, Vol.27 (14), p.1678-1684
Main Authors: Elesber, Ahmad A, Conover, Cheryl A, Denktas, Ali E, Lennon, Ryan J, Holmes, Jr, David R, Overgaard, Michael T, Christiansen, Michael, Oxvig, Claus, Lerman, Lilach O, Lerman, Amir
Format: Article
Language:English
Subjects:
Aged
Angina Pectoris - blood
Angina Pectoris - mortality
Cause of Death
Chronic Disease
Disease-Free Survival
Female
Humans
Male
Multivariate Analysis
Myocardial Infarction - blood
Myocardial Infarction - mortality
Myocardial Revascularization
Pregnancy-Associated Plasma Protein-A - metabolism
Prognosis
Risk Factors
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Summary:Unstable coronary atherosclerotic plaque can be present in patients with chronic stable coronary artery disease (CAD). Our objective was to assess whether measurement of plasma pregnancy-associated plasma protein (PAPP-A) level, a reflection of plaque instability, in patients with chronic stable CAD had an independent prognostic value on the subsequent incidence of death, acute coronary syndrome (ACS), and revascularization. Patients referred for coronary angiography were recruited. A cohort of 103 patients with stable symptoms for at least 6 weeks and with a coronary angiogram showing at least a 50% luminal diameter narrowing formed our study population. Median follow-up was 4.9 years. Mean age was 65+/-10 years. In a multivariable model that included CAD traditional risk factors, ejection fraction, extent of coronary atherosclerosis, prior history of myocardial infarction, prior revascularization, discharge medications, and C-reactive protein, the plasma PAPP-A was found to be significantly associated with the endpoint of future death [adjusted hazard ratio (HR) 5.29; 95% CI 1.27-22.0; P=0.023] and with the endpoint of future death and ACS (adjusted HR 3.56; 95% CI 1.27-10.0; P=0.015), but not with the endpoint of future death and revascularization. Measurement of plasma PAPP-A level in patients with chronic stable CAD has an independent prognostic value on the occurrence of death and ACS.
ISSN:0195-668X
1522-9645
DOI:10.1093/eurheartj/ehl042