Table of Contents
Journal of Angiology
Volume 2014, Article ID 420937, 6 pages
Clinical Study

Pregnancy-Associated Plasma Protein-A Levels and Coronary Angiographic Features in Acute Coronary Syndrome Patients

Department of Cardiology, Faculty of Medicine, Ain Shams University, P.O. Box 11381, Abbassia, Cairo, Egypt

Received 30 September 2013; Revised 16 December 2013; Accepted 24 December 2013; Published 4 February 2014

Academic Editor: Apostolos E. Papalois

Copyright © 2014 Mohamed Shehata. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Pregnancy-associated plasma protein-A (PAPP-A) is a biomarker of plaque rupture, associated with adverse cardiac events in acute coronary syndromes (ACSs) patients. Aim. To identify coronary angiographic (CA) features related to PAPP-A level elevation in ACSs patients. Methods. Forty ACSs patients were enrolled in this prospective cohort study (level of evidence: III-prognostic). Serum samples for PAPP-A quantitation were obtained upon coronary care unit admission. All patients underwent CA and coronary intervention within 6 hours of sampling. Results. Mean age of the study cohort was 57 ± 11 years, (males: 55%, ). Patients with ST-segment elevation myocardial infarction (35%, ) showed significantly higher serum PAPP-A level (11.8 ± 2 µg/mL), compared to non-ST-segment elevation myocardial infarction (15%, ) and unstable angina (50%, ) patients (11 ± 2.6 µg/mL and 8.7 ± 2.3 µg/mL, resp., ). Higher PAPP-A levels were significantly associated with complex culprit lesion morphology (11.8 ± 2 µg/mL for type C lesions, 9.7± 2.5 µg/mL and 7.3 ± 3.5 µg/mL for type B and type A lesions, resp., ), while no relationship to number of diseased coronaries. Conclusion. Higher PAPP-A levels in ACSs patients are associated with unfavorable coronary anatomy and complex angiographic plaque features.