Prognostic value of circulating pregnancy-associated plasma protein levels in patients with chronic stable angina

Ahmad A. Elesber, Cheryl A Conover, Ali E. Denktas, Ryan J. Lennon, David Holmes, Michael T. Overgaard, Michael Christiansen, Claus Oxvig, Lilach O Lerman, Amir Lerman

Research output: Contribution to journalArticle

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Abstract

Aims: Unstable coronary atherosclerotic plaque can be present in patients with chronic stable coronary artery disease (CAD). Our objective was to assess whether measurement of plasma pregnancy-associated plasma protein (PAPP-A) level, a reflection of plaque instability, in patients with chronic stable CAD had an independent prognostic value on the subsequent incidence of death, acute coronary syndrome (ACS), and revascularization. Methods and results: Patients referred for coronary angiography were recruited. A cohort of 103 patients with stable symptoms for at least 6 weeks and with a coronary angiogram showing at least a 50% luminal diameter narrowing formed our study population. Median follow-up was 4.9 years. Mean age was 65±10 years. In a multivariable model that included CAD traditional risk factors, ejection fraction, extent of coronary atherosclerosis, prior history of myocardial infarction, prior revascularization, discharge medications, and C-reactive protein, the plasma PAPP-A was found to be significantly associated with the endpoint of future death [adjusted hazard ratio (HR) 5.29; 95% CI 1.27-22.0; P=0.023] and with the endpoint of future death and ACS (adjusted HR 3.56; 95% CI 1.27-10.0; P=0.015), but not with the endpoint of future death and revascularization. Conclusion: Measurement of plasma PAPP-A level in patients with chronic stable CAD has an independent prognostic value on the occurrence of death and ACS.

Original languageEnglish (US)
Pages (from-to)1678-1684
Number of pages7
JournalEuropean Heart Journal
Volume27
Issue number14
DOIs
StatePublished - Jul 2006

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Stable Angina
Blood Proteins
Coronary Artery Disease
Pregnancy
Acute Coronary Syndrome
Atherosclerotic Plaques
Coronary Angiography
C-Reactive Protein
Angiography
Myocardial Infarction
Incidence
Population

Keywords

  • Pregnancy-associated plasma protein
  • Stable coronary artery disease
  • Unstable atherosclerotic coronary plaque

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Prognostic value of circulating pregnancy-associated plasma protein levels in patients with chronic stable angina. / Elesber, Ahmad A.; Conover, Cheryl A; Denktas, Ali E.; Lennon, Ryan J.; Holmes, David; Overgaard, Michael T.; Christiansen, Michael; Oxvig, Claus; Lerman, Lilach O; Lerman, Amir.

In: European Heart Journal, Vol. 27, No. 14, 07.2006, p. 1678-1684.

Research output: Contribution to journalArticle

Elesber, Ahmad A. ; Conover, Cheryl A ; Denktas, Ali E. ; Lennon, Ryan J. ; Holmes, David ; Overgaard, Michael T. ; Christiansen, Michael ; Oxvig, Claus ; Lerman, Lilach O ; Lerman, Amir. / Prognostic value of circulating pregnancy-associated plasma protein levels in patients with chronic stable angina. In: European Heart Journal. 2006 ; Vol. 27, No. 14. pp. 1678-1684.
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abstract = "Aims: Unstable coronary atherosclerotic plaque can be present in patients with chronic stable coronary artery disease (CAD). Our objective was to assess whether measurement of plasma pregnancy-associated plasma protein (PAPP-A) level, a reflection of plaque instability, in patients with chronic stable CAD had an independent prognostic value on the subsequent incidence of death, acute coronary syndrome (ACS), and revascularization. Methods and results: Patients referred for coronary angiography were recruited. A cohort of 103 patients with stable symptoms for at least 6 weeks and with a coronary angiogram showing at least a 50{\%} luminal diameter narrowing formed our study population. Median follow-up was 4.9 years. Mean age was 65±10 years. In a multivariable model that included CAD traditional risk factors, ejection fraction, extent of coronary atherosclerosis, prior history of myocardial infarction, prior revascularization, discharge medications, and C-reactive protein, the plasma PAPP-A was found to be significantly associated with the endpoint of future death [adjusted hazard ratio (HR) 5.29; 95{\%} CI 1.27-22.0; P=0.023] and with the endpoint of future death and ACS (adjusted HR 3.56; 95{\%} CI 1.27-10.0; P=0.015), but not with the endpoint of future death and revascularization. Conclusion: Measurement of plasma PAPP-A level in patients with chronic stable CAD has an independent prognostic value on the occurrence of death and ACS.",
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AU - Conover, Cheryl A

AU - Denktas, Ali E.

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AU - Holmes, David

AU - Overgaard, Michael T.

AU - Christiansen, Michael

AU - Oxvig, Claus

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