PMID- 28381225
OWN - NLM
STAT- MEDLINE
DCOM- 20171016
LR  - 20210301
IS  - 1475-2840 (Electronic)
IS  - 1475-2840 (Linking)
VI  - 16
IP  - 1
DP  - 2017 Apr 5
TI  - Pregnancy-associated plasma protein-A is a stronger predictor for adverse 
      cardiovascular outcomes after acute coronary syndrome in type-2 diabetes 
      mellitus.
PG  - 45
LID - 10.1186/s12933-017-0526-6 [doi]
LID - 45
AB  - BACKGROUND: The risk prediction of pregnancy-associated plasma protein-A (PAPP-A) 
      for future cardiovascular (CV) events post acute coronary syndrome (ACS) in 
      patients with type-2 diabetes mellitus (T2DM) was investigated in comparison to 
      other risk factors. METHODS: PAPP-A was measured at hospital admission in 320 
      consecutive ACS patients (136 with T2DM and 184 without). All patients were 
      followed for 2 years for occurrence of CV death, non-fatal MI or stroke. Effect 
      of PAPP-A on the CV event risk was estimated using Cox regression models. 
      Receiver operating characteristics (ROC) curves were generated to demonstrate the 
      sensitivity and specificity of PAPP-A in predicting CV events. RESULTS: ACS 
      patients with T2DM had higher PAPP-A (19.29 +/- 16.36 vs. 13.29 +/- 13.90 ng/ml, 
      p < 0.001) and higher rate of CV events 2 years post ACS (27.2 vs. 13.6%, 
      p = 0.002) than those without. Higher levels of PAPP-A were significantly 
      associated with increased risk of CV events during 2-year follow-up [HR = 2.97 
      for 1 SD increase in log(10)(PAPP-A), 95% CI 2.11-4.18, p < 0.001] in T2DM and 
      (HR = 3.16, 95% CI 2.27-4.39, p < 0.001) in non-T2DM. Among patients with T2DM, 
      PAPP-A showed a larger area under the curve (AUC 0.79) that was significantly 
      more predictive than hsCRP (AUC 0.64), eGFR (AUC 0.66) and LVEF < 50% (AUC 0.52); 
      predictive ability did not improve significantly by including those factors into 
      the model. CONCLUSIONS: Patients with T2DM had higher levels of PAPP-A and 
      increased risk of CV events. Elevated PAPP-A compared to other risk factors was a 
      stronger predictor for future CV events 2 years post ACS in patients with T2DM. 
      Trial registration ISRCTN10805074. Registered on 20 January 2017, retrospectively 
      registered.
FAU - Li, Wei-Ping
AU  - Li WP
AD  - Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, 
      Beijing, China.
AD  - Key Laboratory, Metabolic Disorders Related Cardiovascular Disease, Beijing, 
      China.
FAU - Neradilek, Moni B
AU  - Neradilek MB
AD  - The Mountain-Whisper-Light Statistics, Seattle, WA, USA.
FAU - Gu, Fu-Sheng
AU  - Gu FS
AD  - Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, 
      Beijing, China.
FAU - Isquith, Daniel A
AU  - Isquith DA
AD  - Clinical Atherosclerosis Research Lab, Division of Cardiology, University of 
      Washington, Seattle, WA, USA.
FAU - Sun, Zhi-Jun
AU  - Sun ZJ
AD  - Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, 
      Beijing, China.
FAU - Wu, Xing
AU  - Wu X
AD  - Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, 
      Beijing, China.
FAU - Li, Hong-Wei
AU  - Li HW
AD  - Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, 
      Beijing, China. lhw19656@sina.com.
AD  - Key Laboratory, Metabolic Disorders Related Cardiovascular Disease, Beijing, 
      China. lhw19656@sina.com.
FAU - Zhao, Xue-Qiao
AU  - Zhao XQ
AD  - Clinical Atherosclerosis Research Lab, Division of Cardiology, University of 
      Washington, Seattle, WA, USA. xueqiao@uw.edu.
LA  - eng
SI  - ISRCTN/ISRCTN10805074
PT  - Comparative Study
PT  - Journal Article
DEP - 20170405
PL  - England
TA  - Cardiovasc Diabetol
JT  - Cardiovascular diabetology
JID - 101147637
RN  - 0 (Biomarkers)
RN  - EC 3.4.24.- (Pregnancy-Associated Plasma Protein-A)
RN  - EC 3.4.24.79 (PAPPA protein, human)
SB  - IM
MH  - Acute Coronary Syndrome/*blood/diagnosis/etiology/mortality
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Area Under Curve
MH  - Biomarkers/blood
MH  - Case-Control Studies
MH  - Chi-Square Distribution
MH  - Diabetes Mellitus, Type 2/*blood/complications/diagnosis/mortality
MH  - Female
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Non-ST Elevated Myocardial Infarction/blood/diagnosis/*etiology/mortality
MH  - Patient Admission
MH  - Predictive Value of Tests
MH  - Pregnancy-Associated Plasma Protein-A/*analysis
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Prospective Studies
MH  - ROC Curve
MH  - Recurrence
MH  - Risk Assessment
MH  - Risk Factors
MH  - ST Elevation Myocardial Infarction/blood/diagnosis/*etiology/mortality
MH  - Time Factors
MH  - Up-Regulation
PMC - PMC5382447
OTO - NOTNLM
OT  - Acute coronary syndrome
OT  - Cardiovascular outcomes
OT  - Pregnancy-associated plasma protein-A
OT  - Type-2 diabetes mellitus
EDAT- 2017/04/07 06:00
MHDA- 2017/10/17 06:00
PMCR- 2017/04/05
CRDT- 2017/04/07 06:00
PHST- 2017/01/23 00:00 [received]
PHST- 2017/03/27 00:00 [accepted]
PHST- 2017/04/07 06:00 [entrez]
PHST- 2017/04/07 06:00 [pubmed]
PHST- 2017/10/17 06:00 [medline]
PHST- 2017/04/05 00:00 [pmc-release]
AID - 10.1186/s12933-017-0526-6 [pii]
AID - 526 [pii]
AID - 10.1186/s12933-017-0526-6 [doi]
PST - epublish
SO  - Cardiovasc Diabetol. 2017 Apr 5;16(1):45. doi: 10.1186/s12933-017-0526-6.