Molecular Distinction of Circulating Pregnancy-Associated Plasma Protein A in Myocardial Infarction and Pregnancy

Qin, Qiuping; Kokkala, Saara; Lund, Juha; Tamm, Natalia N.; Voipio‐Pulkki, Liisa‐Maria; Pettersson, Kim

doi:10.1373/clinchem.2004.036467

Cited by 62 publications

(37 citation statements)

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“…[215][216][217] Different assays may therefore perform differently. 218 It has been shown that free PAPP-A is a better predictor than total PAPP-A.…”

Section: Pregnancy-associated Plasma Protein Amentioning

confidence: 99%

Randomised Assessment of Treatment using Panel Assay of Cardiac markers – Contemporary Biomarker Evaluation (RATPAC CBE)

Collinson

Gaze²,

Thokala³

et al. 2013

Health Technol Assess

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Reports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The journal is indexed in NHS Evidence via its abstracts included in MEDLINE and its Technology Assessment Reports inform National Institute for Health and Care Excellence (NICE) guidance. HTA research is also an important source of evidence for National Screening Committee (NSC) policy decisions.For more information about the HTA programme please visit the website: http://www.hta.ac.uk/ This reportThe research reported in this issue of the journal was funded by the HTA programme as project number 09/22/16. The contractual start date was in August 2010. The draft report began editorial review in February 2012 and was accepted for publication in June 2012. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HTA programme or the Department of Health. Published by the NIHR Journals Library, produced by Prepress Projects Ltd, Perth, Scotland (www.prepress-projects.co.uk). Objectives: To test the diagnostic accuracy for detecting an acute myocardial infarction (AMI) using highly sensitive troponin assays and a range of new cardiac biomarkers of plaque destabilisation, myocardial ischaemia and necrosis; to test the prognostic accuracy for detecting adverse cardiac events using highly sensitive troponin assays and this range of new cardiac biomarkers; and to estimate the cost-effectiveness of using highly sensitive troponin assays or this range of new cardiac biomarkers instead of an admission and 10-to 12-hour troponin measurement. NIHR Journals LibraryDesign: Substudy of the point-of-care arm of the RATPAC (Randomised Assessment ...

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“…[215][216][217] Different assays may therefore perform differently. 218 It has been shown that free PAPP-A is a better predictor than total PAPP-A.…”

Section: Pregnancy-associated Plasma Protein Amentioning

confidence: 99%

Randomised Assessment of Treatment using Panel Assay of Cardiac markers – Contemporary Biomarker Evaluation (RATPAC CBE)

Collinson

Gaze²,

Thokala³

et al. 2013

Health Technol Assess

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“…In the plasma, PAPP-A circulates either as a free form or as a heterotetrameric complex of the proform of eosinophil major basic protein (proMBP) forming an approximately 500 kDa and called PAPP-A/proMBP ( Fig. 2) [12,13] ProMBP is substituted with both N-and O-linked carbohydrate in addition to a single heparan sulfate moiety, which is believed to occupy the cell-surface binding site of PAPP-A in the circulating PAPP-A/proMBP complex [14,15]. The PAPP-A gene has been assigned to human chromosome 9q33.1 span over 200 kb of DNA, and contains 22 exons [13].…”

Section: Chemistry Of Papp-amentioning

confidence: 99%

First Trimester Maternal Serum Screening Using Biochemical Markers PAPP-A and Free β-hCG for Down Syndrome, Patau Syndrome and Edward Syndrome

Shiefa¹,

Amargandhi²,

Bhupendra³

et al. 2012

Ind J Clin Biochem

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The first trimester screening programme offers a noninvasive option for the early detection of aneuploidy pregnancies. This screening is done by a combination of two biochemical markers i.e. serum free b-human chorionic gonadotrophin (free b-hCG) and pregnancy associated plasma protein A (PAPP-A), maternal age and fetal nuchal translucency (NT) thickness at 11 ? 0-13 ? 6 weeks of gestation. A beneficial consequence of screening is the early diagnosis or trisomies 21, 18 and 13. At 11 ? 0-13 ? 6 weeks, the relative prevalence of trisomies 18 and 13 to trisomy 21 are found to be one to three and one to seven, respectively. All three trisomies are associated with increased maternal age, increased fetal NT and decreased PAPP-A, but in trisomy 21 serum free b-hCG is increased whereas in trisomies 18 and 13 free b-hCG is decreased.Prenatal screening for trisomies based on the analysis of biochemical markers in maternal serum has become an established part of obstetric practice in many countries. Resent interest in prenatal screening for trisomies has focused on the first trimester. Of the biochemical markers that have been investigated, only maternal serum free b-human chorionic gonadotrophin (free b-hCG) and pregnancy associated plasma protein-A (PAPP-A) has been shown to be of value. The goal of first trimester maternal serum screening programs is to identify women at increased risk of having a baby affected with Down syndrome, Patau syndrome, and Edward syndrome defects and those that will benefit from the testing.The association between advancing maternal age [1] and increased risk of trisomy 21 (Table 1) is well known, and pregnant women older than 35 years at delivery are routinely offered invasive prenatal diagnostic testing. The most commonly used test for genetic diagnosis is amniocentesis, but the rate of spontaneous fetal loss related to amniocentesis averages about one in every 200 [2] procedures. Because of this risk, serum analyte testing has become an important, noninvasive first step in detecting patients at risk for congenital abnormalities.Current studies done on first trimester maternal serum screening has shown that the double marker test helps to identify 90 % of women at risk for Down syndrome, 94 % of all major chromosomal defects such as Patau syndrome, Edward syndrome, triploidy and Turner syndrome, and 60 % of other chromosomal defects, such as deletions, partial trisomies, unbalanced translocations, and sex chromosome aneuploidies other than turners [3]. Some of the advantages of first-trimester biochemical screening over second trimester biochemical screening include providing clinicians and patients with the substantial advantage of an earlier diagnosis, higher detection rates for fetal Down syndrome i.e; 90 % [4] or even higher, compared to 80 % for the second trimester quadruple test [5,6] and 70 % for the older triple screening test [7], and detection of most major chromosome abnormalities other than trisomy 21. It also acts as a nonspecific marker for other birth defects inclu...

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“…Recently, FPAPP-A was reported to be the dominant molecular form released to the circulation during ACS (15 ). Measurement of FPAPP-A has therefore been suggested as a more specific and sensitive biomarker in ACS than TPAPP-A, which shows considerable intraindividual fluctuations not related to the acute event.…”

mentioning

confidence: 99%

Free vs Total Pregnancy-Associated Plasma Protein A (PAPP-A) as a Predictor of 1-Year Outcome in Patients Presenting with Non–ST-Elevation Acute Coronary Syndrome

Lund¹,

Wittfooth

Qin

et al. 2010

Clinical Chemistry

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Background: The free fraction of pregnancy-associated plasma protein A (FPAPP-A) was found to be the PAPP-A form released to the circulation in acute coronary syndrome (ACS). We estimated the prognostic value of FPAPP-A vs total PAPP-A (TPAPP-A) concentrations in forecasting death and nonfatal myocardial infarction (combined endpoint) in patients with non–ST-elevation ACS. Methods: We recruited 267 patients hospitalized for symptoms consistent with non–ST-elevation ACS and followed them for 12 months. FPAPP-A, TPAPP-A, C-reactive protein (CRP), and cardiac troponin I (cTnI) were measured at admission; cTnI was also measured at 6–12 h and 24 h. Because of the recently shown interaction between PAPP-A and heparin, we excluded patients treated with any heparin preparations before the admission blood sampling. Results: During the follow-up, 57 (21.3%) patients met the endpoint (22 deaths and 35 nonfatal myocardial infarctions). According to FPAPP-A (<1.27, 1.27–1.74, >1.74 mIU/L) and TPAPP-A (<1.98, 1.98–2.99, >2.99 mIU/L) tertiles, this endpoint was met by 12 (13.5%), 18 (20.2%), 27 (30.3%) (P = 0.02), and 17 (19.1%), 17 (19.1%), 23 (25.8%) (P = 0.54) patients, respectively. After adjusting for age, sex, diabetes, previous myocardial infarction, and ischemic electrocardiogram (ECG) findings, FPAPP-A >1.74 mIU/L [risk ratio (RR) 2.0; 95% CI 1.0–4.1, P = 0.053), increased cTnI, and CRP ≥2.0 mg/L were independent predictors of an endpoint. The prognostic performance of TPAPP-A was inferior to that of FPAPP-A. Conclusions: FPAPP-A seems to be superior as a prognostic marker compared to TPAPP-A, giving independent and additive prognostic information when measured at the time of admission in patients hospitalized for non–ST-elevation ACS.

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Molecular Distinction of Circulating Pregnancy-Associated Plasma Protein A in Myocardial Infarction and Pregnancy

Cited by 62 publications

References 38 publications

Randomised Assessment of Treatment using Panel Assay of Cardiac markers – Contemporary Biomarker Evaluation (RATPAC CBE)

Randomised Assessment of Treatment using Panel Assay of Cardiac markers – Contemporary Biomarker Evaluation (RATPAC CBE)

First Trimester Maternal Serum Screening Using Biochemical Markers PAPP-A and Free β-hCG for Down Syndrome, Patau Syndrome and Edward Syndrome

Free vs Total Pregnancy-Associated Plasma Protein A (PAPP-A) as a Predictor of 1-Year Outcome in Patients Presenting with Non–ST-Elevation Acute Coronary Syndrome

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