Document Detail

Association between plasma pregnancy-associated plasma protein a and restenosis after percutaneous coronary angioplasty.
MedLine Citation:
PMID:  18441451     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Restenosis after percutaneous coronary angioplasty remains an important limitation of this procedure. This study evaluates the association between plasma pregnancy-associated plasma protein A (PAPP-A) levels and restenosis after coronary angioplasty. METHODS AND RESULTS: Blood samples were collected from all patients at baseline, and their levels of PAPP-A, inflammation (high-sensitivity C-reactive protein (hsCRP)) and platelet activation (soluble CD40 ligand (sCD40L)) were determined. Those patients whose PCI was successful underwent a repeat angiography at a median of 6.4 months (interquartile range 6-9.8 months). Their baseline and follow-up angiograms were compared by quantitative coronary angiography to assess the incidence of restenosis. Endpoints were restenosis (> or =50%) and a composite of major adverse cardiac events. Of the 184 patients, 162 patients underwent an angiographic follow up at 6 months. Patients with restenosis had significantly higher PAPP-A levels than those without (19.24+/-2.56 vs 11.95+/-2.32 mIu/L; p<0.001). The PAPP-A levels were significantly correlated to follow up diameter stenosis (r=0.54, p=0.01). Late lumen loss at follow-up was significantly smaller when PAPP-A levels were <12.51 mIu/L (0.55+/-0.61 vs 0.90+/-0.57 mm; p<0.001). The rates for restenosis (28.4 vs 50.6%; p<0.001) and major advent cardiac events (15.6 vs 51.1%, p<0.001) were significantly lower in patients with PAPP-A levels <12.51 mIu/L. Univariate analysis revealed that PAPP-A (p<0.001), hsCRP (p=0.009) and sCD40L (p=0.03) were significantly related to restenosis. However, only PAPP-A could predict restenosis (odds ratio 0.95; 95% confidence interval 0.84-1.13; p=0.02) in multivariate analysis. CONCLUSIONS: The PAPP-A level is a strong independent predictor of restenosis in patients who have undergone coronary angioplasty.
Xu-Ping Li; Sheng Hua Zhou; Jian Jun Tang; Qi Ming Liu; Zheng Fei Fang; Xing Qun Hu; Tao Zhou; Xiang Qian Sheng; Shui Ping Zhao
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  72     ISSN:  1346-9843     ISO Abbreviation:  Circ. J.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-04-28     Completed Date:  2008-09-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  729-33     Citation Subset:  IM    
Department of Cardiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary*
Biological Markers / blood*
Coronary Artery Disease* / blood,  epidemiology,  therapy
Coronary Restenosis* / blood,  diagnosis,  epidemiology
Middle Aged
Multivariate Analysis
Predictive Value of Tests
Pregnancy-Associated Plasma Protein-A / metabolism*
Prospective Studies
Reg. No./Substance:
0/Biological Markers; EC 3.4.24.-/Pregnancy-Associated Plasma Protein-A

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