Growth differentiation factor 15, ischemia modified albumin and pregnancy-associated plasma protein A in patients with coronary artery disease

• Published in: Clinical laboratory (Heidelberg) Vol. 60; no. 6; p. 973
• Main Authors: Fan, Lie Ying, Jin, Zhong Gan, Zong, Ming, Wang, Qing Zhong, Ju, Yi, Sun, Li Shan, Gu, Yu Ying, Yu, Ping, Zhang, Dai Fu, Liu, Zhong Min
• Format: Journal Article
• Language: English
• Published: Germany 2014
• Subjects: Adult; Aged; Aged, 80 and over; Biomarkers - blood; Coronary Artery Disease - blood; Female; Growth Differentiation Factor 15 - blood; Humans; Male; Middle Aged; Pregnancy-Associated Plasma Protein-A - metabolism; Reference Values; ROC Curve; Serum Albumin; Serum Albumin, Human
• ISSN: 1433-6510
• DOI: 10.7754/Clin.Lab.2013.130448

Growth differentiation factor 15 (GDF-15), ischemia modified albumin (IMA) might aid in the early diagnosis and risk stratification of patients with coronary artery disease (CAD), while pregnancy associated plasma protein-A (PAPP-A) can serve as a useful marker of vulnerable plaques and acute coronary syndrome (ACS). We sought to determine serum levels of GDF-15, IMA, PAPP-A and evaluate their diagnostic value in different types of CAD. We detected serum levels of GDF-15, IMA and PAPP-A in 348 patients with CAD and 205 controls. Levels of high-sensitivity C reactive protein, creatine kinase isoenzyme MB, and high-sensitivity cardiac troponin-T, which represent biomarkers of inflammation, damage or necrosis, were also evaluated. There were significant differences of GDF-15, IMA and PAPP-A in patients with CAD compared with the controls, where GDF-15 seemed to be associated with severity of CAD. GDF-15 demonstrated a sensitivity of 84.0% and specificity of 84.8% for diagnosis of UAP, while the negative predictive value was 87.4%. The sensitivity and specificity, negative predictive value of IMA in the diagnosis of UAP were 70.0%, 69.5%, and 70.0%, respectively. PAPP-A had the lowest sensitivity and negative predictive value compared with other markers. GDF-15 demonstrated a significant improvement in earlier prediction and assessment of overall patient risk of UAP comparing to IMA and PAPP-A.