Long-term prognostic utility of PAPP-A and calprotectin in suspected acute coronary syndrome. (April 2013)

• Record Type: Journal Article
• Authors: Mjelva, Øistein Rønneberg; Brügger-Andersen, Trygve; Pönitz, Volker; Grundt, Heidi; Kontny, Frederic; Staines, Harry; Nilsen, Dennis W.T.
• Is Part Of: Scandinavian cardiovascular journal. Volume 47:Number 2(2013:Apr.)
• Page Start: 88
• Page End: 97
• Publication Date: 2013-04
• Subjects: Cardiovascular system -- Diseases -- Periodicals; 617.41
• DOI: 10.3109/14017431.2013.764571
• Languages: English
• ISSNs: 1401-7431

Abstract

<abstract> <title>Abstract</title> <p> <italic>Background.</italic> Vascular inflammation plays a key role in the development of acute coronary syndrome (ACS). Pregnancy-Associated Plasma Protein A (PAPP-A) and calprotectin are two of several novel promising markers of inflammation. The present study evaluates the prognostic utility of these two biomarkers in patients with suspected ACS. <italic>Methods.</italic> Chest pain patients with suspected ACS (N = 871) were consecutively included in a prospective, observational study with a mean follow-up time of 84 months. Blood samples were drawn at admission, prior to treatment with heparin. <italic>Results.</italic> Total mortality was 38.9%. In univariate analyses, high PAPP-A levels were associated with significant increased mortality. The hazard ratio [HR] in quartile (Q) 3 and Q4 were 1.57 (95% confidence interval (CI), 1.14–2.18), p = 0.006, and 1.41 [95% CI 1.02–1.97], p = 0.040, respectively, as compared to Q1. Calprotectin in the upper quartile (Q4) was associated with total mortality [HR1.94 (95% CI 1.42–2.66)], p = < 0.001, the combined endpoint of death or recurrent myocardial infarction (MI) [HR 1.68 (95% CI 1.26–2.24), p = < 0.001], and recurrent MI [HR 1.60 (95% CI 1.06–2.41); p = 0.024]. However, neither PAPP-A nor calprotectin was found to be an independent predictor of future adverse events. <italic>Conclusion.</italic> In this study, high levels of PAPP-A and calprotectin were associated with adverse clinical outcome in chest pain patients with clinically suspected ACS. However, neither of the two biomarkers was an independent predictor of long-term prognosis.</p> </abstract>