Pregnancy-Associated Plasma Protein A as a Marker of Acute Coronary Syndromes

• Published in: The New England journal of medicine Vol. 345; no. 14; pp. 1022 - 1029
• Main Authors: Bayes-Genis, Antoni, Conover, Cheryl A, Overgaard, Michael T, Bailey, Kent R, Christiansen, Michael, Holmes, David R, Virmani, Renu, Oxvig, Claus, Schwartz, Robert S
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 04.10.2001
• Subjects: Acute coronary syndromes; Aged; Angina Pectoris - blood; Angina, Unstable - blood; Angina, Unstable - diagnosis; Atherosclerosis; Biological and medical sciences; Biomarkers - analysis; Biomarkers - blood; C-Reactive Protein - analysis; Cardiology. Vascular system; Cardiovascular disease; Cardiovascular system; Case-Control Studies; Coronary Artery Disease - diagnosis; Coronary Artery Disease - pathology; Coronary heart disease; Coronary vessels; Coronary Vessels - pathology; Death, Sudden, Cardiac; Female; Heart; Heart attacks; Humans; Insulin-Like Growth Factor I - analysis; Investigative techniques, diagnostic techniques (general aspects); Kinases; Male; Medical sciences; Middle Aged; Myocardial Infarction - blood; Myocardial Infarction - diagnosis; Myocardium - pathology; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Pregnancy-Associated Plasma Protein-A - analysis; Prognosis; Regression Analysis; Human; Infarct; Biological marker; Cardiovascular disease; Pregnancy associated plasma protein A; Angina pectoris; Coronary heart disease; Myocardial disease; Blood plasma; Vascular disease; Atherosclerosis; Myocardium; Adult; Elderly
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa003147

PAPP-A, a marker of Down's syndrome, may also be a useful marker of unstable coronary-artery plaques. Patients with acute coronary syndromes are at considerable risk for serious complications and death. Clinical outcomes might be improved by rapid and accurate diagnosis, followed by appropriate therapy. Diagnostic tests for myocardial injury include technetium-99m sestamibi scanning to identify defects in myocardial perfusion, 1 echocardiography to identify abnormalities in left ventricular wall motion, 2 and measurements of circulating levels of the MB isoform of creatine kinase, 3 myoglobin, 4 troponin I, 5 and troponin T 6 to identify myocardial necrosis. Each test reflects different steps of the pathway from coronary occlusion to myocardial ischemia: impairment of coronary-artery flow, ischemic myocardial dysfunction, and eventually, myocardial-tissue necrosis. The . . .