Evaluation of pregnancy-associated plasma protein A as a prognostic indicator in acute coronary syndrome patients

Laterza, Omar; Cameron, Scott J.; Chappell, Derek L; Sokoll, Lori J.; Green, Gary B.

doi:10.1016/j.cccn.2004.05.022

Cited by 44 publications

(26 citation statements)

References 24 publications

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“…In patients with samples drawn < 6 hours after the onset of symptom, PAPP-A seemed to be more sensitive than CK-MB and troponin. 8 Our results are highly significant when compared with the study by Laterza et al 11 who reported a cutoff value of 0.22 mIU/L, with a sensitivity of 66.7% and a specificity of 51.1%.…”

Section: Discussionsupporting

confidence: 46%

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Pregnancy associated plasma protein-A (PAPP-A) as an early marker for the diagnosis of acute coronary syndrome

Gururajan

Gurumurthy

Nayar

et al. 2012

Indian Heart Journal

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Aims and objectives: Pregnancy associated plasma protein-A (PAPP-A), a metalloproteinase plays apivotal role in the pathogenesis of atherosclerosis. Recent studies have reported that elevated levels of PAPP-A, signal the onset of acute coronary syndrome (ACS). We, therefore, proposed to study the analytical competence of PAPP-A in patients admitted to the emergency department with chest pain and finally diagnosed as ACS. Methods and results:Pregnancy associated plasma protein-A was measured using enzyme-linked immunosorbent assay (ELISA) in 485 patients admitted to emergency care unit, of which 89 patients were diagnosed as Non-cardiac chest pain (NCCP). Elevated levels of PAPP-A were observed in patients diagnosed as ACS on comparison with the controls. Receiver operator characteristic (ROC) curve analysis showed PAPP-A to be a good discriminator between ischaemic and nonischaemic patients. The area under the curve was found to be 0.904, 95% CI (0.874-0.929) with 90% sensitivity and 85% specificity (P < 0.0001). The cut-off value from the ROC curve was 0.55 μg/ mL above which PAPP-A was considered to be positive. Conclusion:Pregnancy associated plasma protein-A seems to be a promising biomarker for identification and risk stratification for patients with ACS.

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Section: Discussionsupporting

confidence: 46%

“…Laterza et al 11 concluded PAPP-A to be a modest predictor of adverse events at 30 days. Heeschen et al 6 in a similar study showed PAPP-A was a powerful predictor both in patients with low and high troponin levels.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy associated plasma protein-A (PAPP-A) as an early marker for the diagnosis of acute coronary syndrome

Gururajan

Gurumurthy

Nayar

et al. 2012

Indian Heart Journal

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“…It has been shown that the assay manufactured by DRG Co. (Germany) failed to detect any difference in serum PAPP-A concentrations between healthy controls and patients with ST-segment elevation myocardial infarction (6 ). By contrast, with the assay from Diagnostic System Laboratories, Inc. (DSL), PAPP-A concentrations predicted cardiovascular events after renal transplant (7 ) and cardiovascular events in patients who had presented to the emergency department with acute chest pain (8 ).…”

Section: Julie Goninmentioning

confidence: 99%

Comment on Immunoassays Developed for Pregnancy-Associated Plasma Protein-A (PAPP-A) in Pregnancy May Not Recognize PAPP-A in Acute Coronary Syndromes

Fredericks¹,

Bertomeu‐González

Petrović

et al. 2006

Clinical Chemistry

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“…This fact is likely to have implications in clinical practice, as the antibodies currently used in immunoassays for PAPP-A in ACS are all raised by immunization with PAPP-A isolated from pregnancy serum (14,15 ). In addition, there have been controversial reports on whether serum PAPP-A is a useful marker for ACS (9,10,16,17 ). The inconsistency among laboratories could result from the use of different PAPP-A assays involving different antibodies.…”

mentioning

confidence: 99%

Immunoassays Developed for Pregnancy-Associated Plasma Protein-A (PAPP-A) in Pregnancy May Not Recognize PAPP-A in Acute Coronary Syndromes

et al. 2006

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Background: Pregnancy-associated plasma protein-A (PAPP-A) concentrations are increased in the circulation of patients with acute coronary syndromes (ACS) and are associated with future adverse cardiac events. PAPP-A in ACS differs from PAPP-A in pregnancy in that PAPP-A in ACS is not complexed with the proform of eosinophil major basic protein (proMBP). We investigated the effect of antibody selection on the utility of PAPP-A assays for measurement of PAPP-A in pregnancy and/or ACS, and whether immunoassays for PAPP-A in pregnancy are suitable for PAPP-A in ACS. Methods: We constructed 2-site sandwich time-resolved immunofluorometric assays using 22 monoclonal antibodies raised against pregnancy serum PAPP-A. All antibodies were studied in pairs, with each antibody used as either capture or tracer. We compared the reactivity of each antibody combination with PAPP-A/ proMBP complex derived from pregnancy sera or with uncomplexed PAPP-A extracted from atherosclerotic plaques. Recombinant human PAPP-A and proMBP were also used to determine the specificity of the antibodies. We confirmed all major findings with serum samples collected from patients with myocardial infarction. Results: Six monoclonal antibodies reacted with the proMBP subunit of the PAPP-A/proMBP complex.

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Evaluation of pregnancy-associated plasma protein A as a prognostic indicator in acute coronary syndrome patients

Cited by 44 publications

References 24 publications

Pregnancy associated plasma protein-A (PAPP-A) as an early marker for the diagnosis of acute coronary syndrome

Pregnancy associated plasma protein-A (PAPP-A) as an early marker for the diagnosis of acute coronary syndrome

Comment on Immunoassays Developed for Pregnancy-Associated Plasma Protein-A (PAPP-A) in Pregnancy May Not Recognize PAPP-A in Acute Coronary Syndromes

Immunoassays Developed for Pregnancy-Associated Plasma Protein-A (PAPP-A) in Pregnancy May Not Recognize PAPP-A in Acute Coronary Syndromes

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