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Pregnancy Associated Plasma Protein A, a Novel, Quick, and Sensitive Marker in ST-Elevation Myocardial Infarction
Traditional biomarkers in acute coronary syndromes reflect myocardial necrosis but not the underlying arteriosclerotic disease. Pregnancy-associated plasma protein A (PAPP-A) is a new biomarker in acute coronary syndromes that detects vulnerable plaques in arteriosclerotic disease and identifies acu...
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| Published in: | The American journal of cardiology 2008-05, Vol.101 (10), p.1389-1394 |
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| container_end_page | 1394 |
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| container_title | The American journal of cardiology |
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| creator | Iversen, Kasper K., MD Teisner, Ane S., MD Teisner, Borge, MD Kliem, Anette Thanning, Pia, MD Grande, Peer, MD, DMSc Clemmensen, Peter, MD, DMSc |
| description | Traditional biomarkers in acute coronary syndromes reflect myocardial necrosis but not the underlying arteriosclerotic disease. Pregnancy-associated plasma protein A (PAPP-A) is a new biomarker in acute coronary syndromes that detects vulnerable plaques in arteriosclerotic disease and identifies acute coronary syndromes earlier than traditionally used biomarkers. Information regarding circulating PAPP-A levels in patients with ST elevation myocardial infarctions (STEMIs) is limited and contradictory. The aim of the present study was to describe the presence and time-related pattern of circulating PAPP-A levels in patients with STEMIs. Consecutive patients (n = 354) referred for primary percutaneous intervention because of STEMI were included in the study. Blood samples for the analysis of PAPP-A, creatine kinase-MB (CKMB), and troponin T were drawn at admission and every 6 to 8 hours until biomarkers of myocardial necrosis were consistently decreasing. PAPP-A was measured using a newly developed sandwich enzyme-linked immunosorbent assay technique based on 2 monoclonal antibodies. In total, 1,091 PAPP-A, 1,049 troponin T, and 1,016 CKMB samples were analyzed. Mean PAPP-A values at admission were significantly higher in patients with STEMIs than in those with non–ST elevation myocardial infarctions or unstable angina pectoris (27.6 vs 12.2 mIU/L, p |
| doi_str_mv | 10.1016/j.amjcard.2008.01.015 |
| format | article |
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Pregnancy-associated plasma protein A (PAPP-A) is a new biomarker in acute coronary syndromes that detects vulnerable plaques in arteriosclerotic disease and identifies acute coronary syndromes earlier than traditionally used biomarkers. Information regarding circulating PAPP-A levels in patients with ST elevation myocardial infarctions (STEMIs) is limited and contradictory. The aim of the present study was to describe the presence and time-related pattern of circulating PAPP-A levels in patients with STEMIs. Consecutive patients (n = 354) referred for primary percutaneous intervention because of STEMI were included in the study. Blood samples for the analysis of PAPP-A, creatine kinase-MB (CKMB), and troponin T were drawn at admission and every 6 to 8 hours until biomarkers of myocardial necrosis were consistently decreasing. PAPP-A was measured using a newly developed sandwich enzyme-linked immunosorbent assay technique based on 2 monoclonal antibodies. In total, 1,091 PAPP-A, 1,049 troponin T, and 1,016 CKMB samples were analyzed. Mean PAPP-A values at admission were significantly higher in patients with STEMIs than in those with non–ST elevation myocardial infarctions or unstable angina pectoris (27.6 vs 12.2 mIU/L, p <0.01). In samples drawn <2 hours after admission, the sensitivity of PAPP-A was superior (93%) to that of CKMB (60%) and troponin T (61%). In conclusion, PAPP-A levels are elevated in >90% of patients presenting with STEMIs if measured <6 hours after the onset of symptoms or <2 hours of primary percutaneous coronary intervention. In the early stages of STEMI, PAPP-A seems to be a more sensitive marker of myocardial infarction than CKMB and troponin T.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2008.01.015</identifier><identifier>PMID: 18471447</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Biological and medical sciences ; Biomarkers - blood ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Clinical medicine ; Coronary Angiography ; Coronary heart disease ; Creatine Kinase, MB Form - blood ; Electrocardiography ; Female ; Heart ; Heart attacks ; Humans ; Male ; Medical sciences ; Middle Aged ; Myocardial Infarction - blood ; Myocardial Infarction - diagnosis ; Myocardial Infarction - physiopathology ; Myocarditis. Cardiomyopathies ; Plasma ; Predictive Value of Tests ; Pregnancy ; Pregnancy-Associated Plasma Protein-A - metabolism ; Prognosis ; Proteins ; Retrospective Studies ; Severity of Illness Index ; Time Factors ; Troponin T - blood</subject><ispartof>The American journal of cardiology, 2008-05, Vol.101 (10), p.1389-1394</ispartof><rights>Elsevier Inc.</rights><rights>2008 Elsevier Inc.</rights><rights>2008 INIST-CNRS</rights><rights>Copyright Elsevier Sequoia S.A. May 15, 2008</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c475t-b2d3c2756a9ee7f2d5d9f7cab5f1bda2518400e70c07267b637d234bc22e6c1a3</citedby><cites>FETCH-LOGICAL-c475t-b2d3c2756a9ee7f2d5d9f7cab5f1bda2518400e70c07267b637d234bc22e6c1a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20458331$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18471447$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Iversen, Kasper K., MD</creatorcontrib><creatorcontrib>Teisner, Ane S., MD</creatorcontrib><creatorcontrib>Teisner, Borge, MD</creatorcontrib><creatorcontrib>Kliem, Anette</creatorcontrib><creatorcontrib>Thanning, Pia, MD</creatorcontrib><creatorcontrib>Grande, Peer, MD, DMSc</creatorcontrib><creatorcontrib>Clemmensen, Peter, MD, DMSc</creatorcontrib><title>Pregnancy Associated Plasma Protein A, a Novel, Quick, and Sensitive Marker in ST-Elevation Myocardial Infarction</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Traditional biomarkers in acute coronary syndromes reflect myocardial necrosis but not the underlying arteriosclerotic disease. Pregnancy-associated plasma protein A (PAPP-A) is a new biomarker in acute coronary syndromes that detects vulnerable plaques in arteriosclerotic disease and identifies acute coronary syndromes earlier than traditionally used biomarkers. Information regarding circulating PAPP-A levels in patients with ST elevation myocardial infarctions (STEMIs) is limited and contradictory. The aim of the present study was to describe the presence and time-related pattern of circulating PAPP-A levels in patients with STEMIs. Consecutive patients (n = 354) referred for primary percutaneous intervention because of STEMI were included in the study. Blood samples for the analysis of PAPP-A, creatine kinase-MB (CKMB), and troponin T were drawn at admission and every 6 to 8 hours until biomarkers of myocardial necrosis were consistently decreasing. PAPP-A was measured using a newly developed sandwich enzyme-linked immunosorbent assay technique based on 2 monoclonal antibodies. In total, 1,091 PAPP-A, 1,049 troponin T, and 1,016 CKMB samples were analyzed. Mean PAPP-A values at admission were significantly higher in patients with STEMIs than in those with non–ST elevation myocardial infarctions or unstable angina pectoris (27.6 vs 12.2 mIU/L, p <0.01). In samples drawn <2 hours after admission, the sensitivity of PAPP-A was superior (93%) to that of CKMB (60%) and troponin T (61%). In conclusion, PAPP-A levels are elevated in >90% of patients presenting with STEMIs if measured <6 hours after the onset of symptoms or <2 hours of primary percutaneous coronary intervention. In the early stages of STEMI, PAPP-A seems to be a more sensitive marker of myocardial infarction than CKMB and troponin T.</description><subject>Biological and medical sciences</subject><subject>Biomarkers - blood</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Clinical medicine</subject><subject>Coronary Angiography</subject><subject>Coronary heart disease</subject><subject>Creatine Kinase, MB Form - blood</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - blood</subject><subject>Myocardial Infarction - diagnosis</subject><subject>Myocardial Infarction - physiopathology</subject><subject>Myocarditis. 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Cardiomyopathies</topic><topic>Plasma</topic><topic>Predictive Value of Tests</topic><topic>Pregnancy</topic><topic>Pregnancy-Associated Plasma Protein-A - metabolism</topic><topic>Prognosis</topic><topic>Proteins</topic><topic>Retrospective Studies</topic><topic>Severity of Illness Index</topic><topic>Time Factors</topic><topic>Troponin T - blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Iversen, Kasper K., MD</creatorcontrib><creatorcontrib>Teisner, Ane S., MD</creatorcontrib><creatorcontrib>Teisner, Borge, MD</creatorcontrib><creatorcontrib>Kliem, Anette</creatorcontrib><creatorcontrib>Thanning, Pia, MD</creatorcontrib><creatorcontrib>Grande, Peer, MD, DMSc</creatorcontrib><creatorcontrib>Clemmensen, Peter, MD, DMSc</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Iversen, Kasper K., MD</au><au>Teisner, Ane S., MD</au><au>Teisner, Borge, MD</au><au>Kliem, Anette</au><au>Thanning, Pia, MD</au><au>Grande, Peer, MD, DMSc</au><au>Clemmensen, Peter, MD, DMSc</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pregnancy Associated Plasma Protein A, a Novel, Quick, and Sensitive Marker in ST-Elevation Myocardial Infarction</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2008-05-15</date><risdate>2008</risdate><volume>101</volume><issue>10</issue><spage>1389</spage><epage>1394</epage><pages>1389-1394</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>Traditional biomarkers in acute coronary syndromes reflect myocardial necrosis but not the underlying arteriosclerotic disease. Pregnancy-associated plasma protein A (PAPP-A) is a new biomarker in acute coronary syndromes that detects vulnerable plaques in arteriosclerotic disease and identifies acute coronary syndromes earlier than traditionally used biomarkers. Information regarding circulating PAPP-A levels in patients with ST elevation myocardial infarctions (STEMIs) is limited and contradictory. The aim of the present study was to describe the presence and time-related pattern of circulating PAPP-A levels in patients with STEMIs. Consecutive patients (n = 354) referred for primary percutaneous intervention because of STEMI were included in the study. Blood samples for the analysis of PAPP-A, creatine kinase-MB (CKMB), and troponin T were drawn at admission and every 6 to 8 hours until biomarkers of myocardial necrosis were consistently decreasing. PAPP-A was measured using a newly developed sandwich enzyme-linked immunosorbent assay technique based on 2 monoclonal antibodies. In total, 1,091 PAPP-A, 1,049 troponin T, and 1,016 CKMB samples were analyzed. Mean PAPP-A values at admission were significantly higher in patients with STEMIs than in those with non–ST elevation myocardial infarctions or unstable angina pectoris (27.6 vs 12.2 mIU/L, p <0.01). In samples drawn <2 hours after admission, the sensitivity of PAPP-A was superior (93%) to that of CKMB (60%) and troponin T (61%). In conclusion, PAPP-A levels are elevated in >90% of patients presenting with STEMIs if measured <6 hours after the onset of symptoms or <2 hours of primary percutaneous coronary intervention. In the early stages of STEMI, PAPP-A seems to be a more sensitive marker of myocardial infarction than CKMB and troponin T.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>18471447</pmid><doi>10.1016/j.amjcard.2008.01.015</doi><tpages>6</tpages></addata></record> |
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| subjects | Biological and medical sciences Biomarkers - blood Cardiology Cardiology. Vascular system Cardiovascular Clinical medicine Coronary Angiography Coronary heart disease Creatine Kinase, MB Form - blood Electrocardiography Female Heart Heart attacks Humans Male Medical sciences Middle Aged Myocardial Infarction - blood Myocardial Infarction - diagnosis Myocardial Infarction - physiopathology Myocarditis. Cardiomyopathies Plasma Predictive Value of Tests Pregnancy Pregnancy-Associated Plasma Protein-A - metabolism Prognosis Proteins Retrospective Studies Severity of Illness Index Time Factors Troponin T - blood |
| title | Pregnancy Associated Plasma Protein A, a Novel, Quick, and Sensitive Marker in ST-Elevation Myocardial Infarction |
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