Association Between Plasma Pregnancy-Associated Plasma Protein A and Restenosis After Percutaneous Coronary Angioplasty
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概要
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Background Restenosis after percutaneous coronary angioplasty remains an important limitation of this procedure. This study evaluates the association between plasma pregnancy-associated plasma protein A (PAPP-A) levels and restenosis after coronary angioplasty. Methods and Results Blood samples were collected from all patients at baseline, and their levels of PAPP-A, inflammation (high-sensitivity C-reactive protein (hsCRP)) and platelet activation (soluble CD40 ligand (sCD40L)) were determined. Those patients whose PCI was successful underwent a repeat angiography at a median of 6.4 months (interquartile range 6-9.8 months). Their baseline and follow-up angiograms were compared by quantitative coronary angiography to assess the incidence of restenosis. Endpoints were restenosis (>50%) and a composite of major adverse cardiac events. Of the 184 patients, 162 patients underwent an angio-graphic follow up at 6 months. Patients with restenosis had significantly higher PAPP-A levels than those without (19.24±2.56 vs 11.95±2.32mIu/L; p<0.001). The PAPP-A levels were significantly correlated to follow up diameter stenosis (r=0.54, p=0.01). Late lumen loss at follow-up was significantly smaller when PAPP-A levels were <12.51mIu/L (0.55±0.61 vs 0.90±0.57mm; p<0.001). The rates for restenosis (28.4 vs 50.6%; p<0.001) and major advent cardiac events (15.6 vs 51.1%, p<0.001) were significantly lower in patients with PAPP-A levels <12.51mIu/L. Univariate analysis revealed that PAPP-A (p<0.001), hsCRP (p=0.009) and sCD40L (p=0.03) were significantly related to restenosis. However, only PAPP-A could predict restenosis (odds ratio 0.95; 95% confidence interval 0.84-1.13; p=0.02) in multivariate analysis. Conclusions The PAPP-A level is a strong independent predictor of restenosis in patients who have undergone coronary angioplasty.
- 2008-04-20
著者
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Li Xu-Ping
Department of Cardiology, The Second Xiangya Hospital, Central South University
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Zhou Sheng
Department of Cardiology, The Second Xiangya Hospital, Central South University
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Tang Jian
Department of Cardiology, The Second Xiangya Hospital, Central South University
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Liu Qi
Department of Cardiology, The Second Xiangya Hospital, Central South University
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Fang Zheng
Department of Cardiology, The Second Xiangya Hospital, Central South University
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Hu Xing
Department of Cardiology, The Second Xiangya Hospital, Central South University
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Zhou Tao
Department of Cardiology, The Second Xiangya Hospital, Central South University
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Sheng Xiang
Department of Cardiology, The Second Xiangya Hospital, Central South University
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Zhao Shui
Department of Cardiology, The Second Xiangya Hospital, Central South University
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Zhou Tao
Department Of Applied Chemistry Kyushu Institute Of Technology
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Zhou Tao
Department Of Cardiology The Second Xiangya Hospital Central South University
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Tang Jian
Department Of Cardiology The Second Xiangya Hospital Central South University
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Zhao Shui
Department Of Cardiology The Second Xiangya Hospital Central South University
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Fang Zheng
Department Of Cardiology The Second Xiangya Hospital Central South University
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Zhou Sheng
Department Of Cardiology The Second Xiangya Hospital Central South University
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Li Xu-ping
Department Of Cardiology Second Xiangya Hospital Central South University
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Li Xu-ping
Department Of Cardiology The Second Xiangya Hospital Central South University
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Sheng Xiang
Department Of Cardiology The Second Xiangya Hospital Central South University
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Liu Qi
Department Of Cardiology The Second Xiangya Hospital Central South University
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Hu Xing
Department Of Cardiology The Second Xiangya Hospital Central South University
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