The diagnostic value of pregnancy-associated plasma protein-a (papp-a)‎ in male patients with acute coronary syndrome

الملخص EN

Background : Acute coronary syndromes (ACS) are major causes of emergency hospital admission and mortality.

Biochemical markers of Myocardial injury plays an essential role in assessment and treatment of ACS patients.

Aim : The aim of this study is to determine the diagnostic performance of serum PAPP-A in patients with ACS in comparison to some myocardial markers, namely : Troponin I (cTn I), Creatine-kinase (CK), CK-2 and Lactate dehydrogenase (LD).

Subjects : The present study was conducted on 75 male subjects, divided into 3 groups : A Control group (n=20) of healthy volunteers and two Patients groups included 55 patients with ACS divided as follows : 23 patients with unstable angina (UA) and 32 patients with acute myocardial infarction (AMI).

Methods : To all studied subjects the following was done : full clinical examination, electrocardiography, echocardiography and laboratory tests included : Serum levels of glucose, urea , creatinine, uric acid and lipid profile as well as ALT, AST, LD, CK and Ck- 2 activities.

Troponin I test (cTnI), high sensitive C- Reactive Protein (hsCRP) and PAPP-A.

Conclusion : From the obtained results, the following could be concluded: 1.

PAPP-A levels showed no significant difference between the three studied groups (control, UA, AMI), while PAPP-A was higher in Troponin I positive AMI patients than in Troponin I negative AMI patients.

2.

No correlation was found between PAPP-A and the studied inflammatory markers or myocardial markers namely hsCRP, total CK, CK -2 and LD.

3.

PAPP-A is a good negative test as it had the best specificity, but it had the least diagnostic sensitivity and efficiency among the studied parameters (CK-2, hs CRP, LD, CK) in patients groups.

Therefore, PAPP-A can be considered of doubtful (limited) value as a myocardial marker in ACS patients.