Clinical significance of pregnancy-associated plasma protein-A in acute coronary syndrome

Objective To evaluate the value of pregnancy-associated plasma protein-A(PAPP-A) in the diagnosis of acute coronary syndrome(ACS).Methods To measure PAPP-A,C reactive protein in 56 patients with AMI,26 patients with UAP,20 patients with SAP and 20 controls.In the different groups,clinical data were compared with one-way ANOVA,PAPP-A and CRP were evaluated by Kruskal-Wallis test,correlation between PAPP-A and CRP,CK-MB,TNT were assessed by Spearman's rank-correlation analysis,and early diagnostic value of PAPP-A and CRP for ACS were compared by calculating the area under the ROC curve.Results The median PAPP-A and CRP levels were significantly higher in AMI and UAP groups than in the control and SAP groups(P0.01,P0.001).There were no statistical significances in PAPP-A and CRP levels between UAP group and AMI group,between SAP group and control group(P0.05).The level of CRP significantly associated with the PAPP-A level in the patients with ACS(r=0.898,P0.01).There was no significant relationship between the levels of PAPP-A and TNT,CK-MB.The area under the ROC curve for PAPP-A was 0.91±0.08,for CRP was 0.78±0.05.Conclusion PAPP-A is a novel marker for the early diagnosis of ACS.PAPP-A levels associated with plaque stability and was predictive parameter for plaque stability,but it is not a marker for AMI.