Objective To investigate the relationship between the levels of circulating pregnancy-associated plasma protein A (PAPP-A), a novel marker of atherosclerotic plaque activity, and mid-term outcome of percutaneous coronary intervention (PCI) in patients with non-ST-elevation acute coronary syndrome (NSTEACS).
Methods Eighty six patients who had single coronary artery stenosis, 58 with unstable angina and 28 with non-ST-elevation acute myocardial infarction, were measured circulating PAPP-A levels and high-sensitivity C-reactive protein (hs-CRP) before PCI. The morphology of stenotic lesions, pro-PCI and post-PCI TIMI myocardial perfusion grade in the area of culprit vessels were analysed as well. The follow-up endpoints were cardiovascular events, which included cardiac death, non-fatal myocardial infarction, target vessel revascularisation and rehospitalisation owing to angina.
Results Patients with cardiac events had higher levels of hs-CRP (p=0.016) and PAPP-A ((28.55±20.21) mIu/l vs (19.37±15.24) mIu/l, p=0.007) compared with those without events. There were more patients with hyperlipoidemia and complex lesions in the group with events, and more males too. During (9.7±3.0) months follow-up, there were nineteen patients (22%) undergoing cardiac events. Patients with lower PAPP-A levels had higher event-free survival rates (log rank=7.881, p=0.049), and PAPP-A≥15.41mIu/l was a strong predictive factor for combined endpoint (OR=2.23, 95% CI: 1.27 to 5.33, p=0.021).
Conclusions The PAPP-A levels can predict the mid-term outcome of PCI in patients with NSTEACS and single vessel stenosis.