Consuegra-Sanchez Luciano, Petrovic Ivana, Cosin-Sales Juan, Holt David W, Christiansen Michael, Kaski Juan Carlos
Cardiovascular Biology Research Centre, Division of Cardiac and Vascular Sciences, St George's Hospital Medical School, University of London, London, UK.
Clin Chim Acta. 2008 May;391(1-2):18-23. doi: 10.1016/j.cca.2008.01.012. Epub 2008 Jan 18.
Pregnancy-associated plasma protein-A (PAPP-A) concentrations predict outcome in patients with acute coronary syndromes. PAPP-A levels and PAPP-A/pro-MBP ratio are increased in chronic stable angina (CSA) patients with complex coronary artery stenoses. Little is known however, about the long-term prognostic value of PAPP-A and pro-MBP in "real-life" CSA patients. We sought to assess whether PAPP-A, the proform of eosinophil major basic protein (pro-MBP) and PAPP-A/pro-MBP levels predict long-term all-cause mortality in patients with CSA.
We recruited 663 consecutive patients (169 women [25.5%]; mean age 62.9+/-9.7 years) undergoing routine diagnostic coronary angiography. Samples for PAPP-A and pro-MBP were taken at study entry. Patients were followed for a median of 8.8 years (interquartile range 3 - 10.6 years).
106 patients (16%) died during follow-up. On a Cox proportional hazards model, increased PAPP-A concentration (>4.8 mIU/L) was an independent predictor of the occurrence of all-cause mortality (HR 1.953, 95% CI 1.135-3.36, p=.016). Neither pro-MBP nor PAPP-A/pro-MBP ratio were markers of all-cause mortality (p=.45 and .54, respectively).
High PAPP-A levels (>4.8 mIU/L) showed an association with all-cause mortality during long-term follow-up in patients with CSA.
妊娠相关血浆蛋白A（PAPP-A）浓度可预测急性冠脉综合征患者的预后。在患有复杂冠状动脉狭窄的慢性稳定型心绞痛（CSA）患者中，PAPP-A水平及PAPP-A/前髓磷脂碱性蛋白（pro-MBP）比值升高。然而，对于“现实生活”中的CSA患者，PAPP-A和pro-MBP的长期预后价值知之甚少。我们旨在评估PAPP-A、嗜酸性粒细胞主要碱性蛋白前体（pro-MBP）及PAPP-A/pro-MBP水平是否可预测CSA患者的长期全因死亡率。
我们连续招募了663例接受常规诊断性冠状动脉造影的患者（169例女性[25.5%]；平均年龄62.9±9.7岁）。在研究开始时采集PAPP-A和pro-MBP的样本。对患者进行了中位时间为8.8年（四分位间距3 - 10.6年）的随访。
106例患者（16%）在随访期间死亡。在Cox比例风险模型中，PAPP-A浓度升高（>4.8 mIU/L）是全因死亡率发生的独立预测因素（风险比1.953，95%置信区间1.135 - 3.36，p = 0.016）。pro-MBP和PAPP-A/pro-MBP比值均不是全因死亡率的标志物（p分别为0.45和0.54）。
在CSA患者的长期随访中，高PAPP-A水平（>4.8 mIU/L）与全因死亡率相关。
