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Interventional cardiology
The prognostic value of pregnancy-associated plasma protein A for outcome of percutaneous coronary intervention in patients with non-ST-elevation acute coronary syndrome
  1. Mei Weiyi,
  2. Du Zhimin,
  3. Hu Chengheng,
  4. Li Yi,
  5. Luo Chufan,
  6. Wu Guifu
  1. Department Of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China

Abstract

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.

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