Document Detail

Release patterns of pregnancy-associated plasma protein A in patients with acute coronary syndromes assessed by an optimized monoclonal antibody assay.
MedLine Citation:
PMID:  18855223     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Pregnancy-associated plasma protein A (PAPP-A) is expressed in eroded and ruptured atheromatous plaques, and circulating levels are elevated in acute coronary syndromes (ACS). Our objective was to investigate release patterns of PAPP-A in ACS and whether they differ among different types of ACS. METHODS: In 40 patients, PAPP-A concentrations were measured in serially collected samples assessed by a novel ELISA technique. The patients were grouped according to type of ACS. RESULTS: Release patterns for ST elevation myocardial infarction (STEMI) patients who underwent primary percutaneous coronary intervention (pPCI) showed a single substantial PAPP-A increase shortly after pPCI, followed by an abrupt return to normal levels without secondary peaks. STEMI, high-risk and low-risk non-ST elevation myocardial infarction/unstable angina pectoris (NSTEMI/UAP) patients without pPCI showed highly variable patterns with primary peaks followed by secondary PAPP-A increases. All patients with elevated PAPP-A levels reached the upper reference level within 24 h. There was a significant difference in median peak levels between STEMI (23.2 mIU/L) and low-risk ACS patients (6.35 mIU/L) (p = 0.004) and between high-risk (median = 15.3 mIU/L) and low-risk ACS patients (p = 0.01). Among high-risk ACS patients, NSTEMI patients had significantly higher peak levels than UAP patients (p = 0.003). CONCLUSION: PAPP-A serum levels increase above normal values within 24 h after onset of symptoms in ACS. There are significant differences in PAPP-A peak levels and release patterns across the spectrum of ACS patients.
Mikkel Schoos; Kasper Iversen; Ane Teisner; Børge Teisner; Pia Thaning; Anette Kliem; Peer Grande; Peter Clemmensen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Scandinavian journal of clinical and laboratory investigation     Volume:  69     ISSN:  1502-7686     ISO Abbreviation:  Scand. J. Clin. Lab. Invest.     Publication Date:  2009  
Date Detail:
Created Date:  2009-02-09     Completed Date:  2009-03-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0404375     Medline TA:  Scand J Clin Lab Invest     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  121-7     Citation Subset:  IM    
Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark.
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MeSH Terms
Acute Coronary Syndrome / metabolism*
Antibodies, Monoclonal / immunology*
Immunoassay / methods*
Middle Aged
Pregnancy-Associated Plasma Protein-A / metabolism*
Reg. No./Substance:
0/Antibodies, Monoclonal; EC 3.4.24.-/Pregnancy-Associated Plasma Protein-A

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