Evaluation on the relationship between pregnancy associated plasma protein-A and intravascular ultrasound detected culprit coronary plaque morphology in patients with unstable angina
10.3760/cma.j.issn.0253-3758.2011.05.010
- VernacularTitle:血管内超声评价妊娠相关蛋白A水平与不稳定性心绞痛罪犯病变形态的关系
- Author:
Xiao-Fan WU
1
;
Yun-Dai CHEN
;
Shu-Zheng L(U)
;
Fang REN
;
Chang-Jiang GE
;
Ze-Ning JIN
;
Kai TAN
;
Feng XU
Author Information
1. 首都医科大学附属北京安贞医院
- Keywords:
Coronary disease;
Pregnancy associated plasma protein-A;
Ultrasonography,interventional
- From:
Chinese Journal of Cardiology
2011;39(5):424-428
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the relationship between pregnancy associated plasma protein-A (PAPP-A)and culprit coronary plaque morphology in patients with unstable angina(UA).Methods Sixtyeight UA patients undergoing diagnostic coronary angiography and intravascular ultrasound were included in this study.A sandwich enzyme-linked immunosorbent assay technique was used to assay the circulating PAPP-A.Plaque characteristics of culprit lesion were analyzed for UA patients with various PAPP-A levels.Results PAPP-A level was significantly higher in high-risk UA than in non-high-risk UA[(19.9±20.1)mIU/L vs.(6.9 ±5.7)mIU/L,P=0.002].Optimal threshold of PAPP-A to prediet high-risk UA was determined as 11.0 mIU/L with a sensitivity of 78.6%and a specificity of 77.5%.Patients with higher PAPP-A level(≥11.0 mIU/L)was associated with larger external elastic membrane cross-sectional area,plaque area and more plaque burden compared with patients with lower PAPP-A Ievel(all P<0.01).Positive remodeling,attenuated plaque and plaque rupture were significantly more often in patients with higher PAPP-A than in patients with lower PAPP-A level(all P<0.01).PAPP-A≥11.0 mIU/L(OR=5.921,P=0.014)and attenuated plaque(OR=7.541,P=0.038)were independent risk predictors for high-risk UA.Conclusions PAPP-A was associated with instability of culprit plaque in UA patients.PAPP-A≥11.0 mIU/L and attenuated plaque were independent predictors for high-risk UA.
