PMID- 19325014
OWN - NLM
STAT- MEDLINE
DCOM- 20090619
LR  - 20190722
IS  - 1530-8561 (Electronic)
IS  - 0009-9147 (Linking)
VI  - 55
IP  - 6
DP  - 2009 Jun
TI  - Intravenous administration of low molecular weight and unfractionated heparin 
      elicits a rapid increase in serum pregnancy-associated plasma protein A.
PG  - 1214-7
LID - 10.1373/clinchem.2008.108738 [doi]
AB  - BACKGROUND: Pregnancy-associated plasma protein A (PAPP-A) has been suggested as 
      a useful diagnostic and prognostic marker in acute coronary syndromes. Because 
      low molecular weight heparin (LMWH) and unfractionated heparin (UFH) are commonly 
      used in these cases, we analyzed the effects of intravenous administration of 
      these heparins on serum PAPP-A concentrations. METHODS: Serum concentrations of 
      total and free PAPP-A were analyzed in 14 patients on chronic hemodialysis and in 
      10 coronary angiography patients. Ten of the dialysis patients received standard 
      LMWH anticoagulation at the start of dialysis, and 4 were treated with a 
      heparin-free method. Two of the patients on heparin-free hemodialysis received a 
      reduced LMWH bolus 2 h after the start of dialysis. All angiography patients 
      received UFH at the start of the procedure, and 1 patient received 2 extra 
      boluses of UFH. Serum PAPP-A concentrations were analyzed before and during the 
      dialysis session and during the coronary angiography examination. RESULTS: A 
      rapid increase in total PAPP-A (median, 25-fold) was seen in all patients within 
      5 min of administration for both LMWH and UFH boluses. This response was due to 
      an increase in free PAPP-A in the serum. PAPP-A did not increase significantly in 
      the patients who underwent heparin-free hemodialysis. Repeated heparin boluses 
      induced a new PAPP-A release. In vitro addition of heparins to samples of whole 
      blood did not increase PAPP-A concentrations. CONCLUSIONS: Intravenous 
      administration of heparin induces an intense and rapid increase in free PAPP-A in 
      the serum. We recommend that this effect be considered when PAPP-A is assessed as 
      a biomarker in acute coronary syndromes.
FAU - Tertti, Risto
AU  - Tertti R
AD  - Department of Internal Medicine, Turku University Hospital, Turku, Finland. 
      risto.tertti@tyks.fi
FAU - Wittfooth, Saara
AU  - Wittfooth S
FAU - Porela, Pekka
AU  - Porela P
FAU - Airaksinen, K E
AU  - Airaksinen KE
FAU - Metsarinne, Kaj
AU  - Metsarinne K
FAU - Pettersson, Kim
AU  - Pettersson K
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20090326
PL  - England
TA  - Clin Chem
JT  - Clinical chemistry
JID - 9421549
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
RN  - EC 3.4.24.- (Pregnancy-Associated Plasma Protein-A)
SB  - IM
MH  - Coronary Angiography
MH  - Heparin/*administration & dosage
MH  - Heparin, Low-Molecular-Weight/*administration & dosage
MH  - Humans
MH  - Infusions, Intravenous
MH  - Pregnancy-Associated Plasma Protein-A/*metabolism
MH  - Renal Dialysis
EDAT- 2009/03/28 09:00
MHDA- 2009/06/20 09:00
CRDT- 2009/03/28 09:00
PHST- 2009/03/28 09:00 [entrez]
PHST- 2009/03/28 09:00 [pubmed]
PHST- 2009/06/20 09:00 [medline]
AID - clinchem.2008.108738 [pii]
AID - 10.1373/clinchem.2008.108738 [doi]
PST - ppublish
SO  - Clin Chem. 2009 Jun;55(6):1214-7. doi: 10.1373/clinchem.2008.108738. Epub 2009 
      Mar 26.