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European Heart Journal Advance Access originally published online on July 29, 2005
European Heart Journal 2005 26(20):2093-2098; doi:10.1093/eurheartj/ehi433
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© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Relationship among pregnancy associated plasma protein-A levels, clinical characteristics, and coronary artery disease extent in patients with chronic stable angina pectoris

Juan Cosin-Sales1, Juan Carlos Kaski1,*, Michael Christiansen2,3, Paul Kaminski1, Claus Oxvig4, Michael T. Overgaard4, Della Cole1 and David W. Holt1

1Department of Cardiac and Vascular Sciences, St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK
2Department of Clinical Biochemistry, Statens Serum Institut, Copenhagen, Denmark
3Copenhagen Heart Arrhythmia Research Center, Copenhagen, Denmark
4Department of Molecular Biology, Science Park, University of Aarhus, Aarhus, Denmark

Received 21 September 2004; revised 21 June 2005; accepted 30 June 2005; online publish-ahead-of-print 29 July 2005.

* Corresponding author. Tel: +44 020 87255901; fax: +44 020 87253328. E-mail address: jkaski{at}sghms.ac.uk

See page 2075 for the editorial comment on this article (doi:10.1093/eurheartj/ehi475)

Aims To assess, in chronic stable angina (CSA) patients, the relationship among clinical characteristics and cardiovascular risk factors, extent of coronary artery disease (CAD), and pregnancy-associated plasma protein-A (PAPP-A) levels.

Methods and results We studied 643 CSA patients (63±10 years, 482 men) undergoing diagnostic coronary angiography; 97 with angiographically normal coronary arteries or <50% stenosis, 127 with single vessel disease (VD), and 419 with multi-VD. Patients' age, gender, cardiovascular risk factors, body mass index, history of previous myocardial infarction, angina class, left ventricular ejection fraction (LVEF), and treatment were assessed at study entry. PAPP-A levels (mIU/L) were higher in men than in women (6.2±2.4 vs. 5.2±1.8; P<0.001) and in hypertensive vs. normotensive patients (6.4±2.8 vs. 5.8±2.1; P=0.01). PAPP-A correlated directly with age (r=0.19, P<0.001) and inversely with LVEF (r=–0.11, P=0.01). Patients with multivessel disease (VD) had higher PAPP-A levels (6.45±2.58) than those with single-VD (5.49±1.54, P<0.001) or normal coronaries (4.62±1.17, P<0.001). Male gender, age, history of a previous MI, hypercholesterolaemia, and PAPP-A levels were independent predictors for the presence of CAD.

Conclusion In CSA patients PAPP-A levels correlate with age, male gender, hypertension, and CAD extent. In the present study, PAPP-A was an independent predictor for the presence and extent of CAD.

Key Words: Chronic stable angina • PAPP-A • Inflammation • Coronary artery disease extent


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