Changes Of Serum Placental Growth Factor Level And Pregnancy-associated Plasma Protein-A Level During Percutaneous Coronary Intervension And Clinicl Significance

The activation of inflammation plays an important role in coronary heart disease.Researchshows that placental growth factor(PLGF) and pregnancy associated plasmaProtein-A(PAPP-A) can be used as inflammatory symbol for coronary artery plaque stability andreflect the state of inflammation,which are independent predictors as early diagnosis andprognosis for coronary heart disease.But it reported less on PCI surgery for CHD and influenceat clinical outcomes.This study is to investigate the PLGF and PAPP-A level trend before andafter PCI ,and the correlation of them.We can know the predictive value for major adversecardiac events happen 6 months later.Methods: The total of 70 patients with cornary heart disease(CHD),who would be treatedby selective PCI,were enrolled.43 males and 27 females,with average age of 60.01±8,13years.The patients were divided into three groups by the results of coronary angiography:singlevessel lesion group（29 cases）,double vessel lesion group (26 cases),three vessle lesion group (15cases). Another 30 healthy people were in control group(17 males and 9 females),with averageage of 64.23±5.37 years.They were eliminated from coronary heart disease by routine 12 leadECG,, Emission Computed Tomography(ECT)，exercise ECG, or coronary angiography. Nostatistical difference existed in age and sex between CHD and control group。The concentrationof PLGF、PAPP-A were measured by the method of ELISA. Venous blood were withdrawn fromCHD group before PCI and on the 24th,72th hours after PCI respectivelyblood specimens weregotten from vein only once(measurement served as normal contral)In the control group.Theserum level of PIGF and PAPP-A were observed before and after PCI..The relationship betweenPIGF and PAPP-A was analyzed. There was 6 months for The postoperative follow-up,andcardiovascular events were observed.Throughout all of these,we investigate the short-termprognostic value of PIGF and PAPP-A on outcomes of patients with coronary heart disease.Results:(1)Contrast of indexes before PCI between CHD group and normal control group:Serum levels of PLGF, PAPP-A in patients with CHD were significantly higher than those inhealthy control group.(2)Comparison of indexes before PCI amon g single vessel group,double vessel group andthree vessle group:The serum PlGF level in single vessel group was significantly lower than those in double-vessel group,and the serum PlGF level in double-vessel group was signicantlylower than those in three vessel group.The serum PAPP-A level in single vessel group anddouble vessel group were significantly higher than the normal contral group,but three vesselgroup was lower than the single and double vessel groups,and didn’t have significant differencewith the normal contral group.(3)Changes of serum PlGF，PAPP-A levels before and after PCI: PIGF levels on the first dayafter PCI were elevated as compared with those before PCI,obviously peaked on the 3 rd dayafter PCI. PAPP-A levels on the first day after PCI were elevated as compared with those beforePCI,and declined on the 3 rd day after PCI.These differences were statistically significant.(4)The correlation between PIGF and PAPP-A is positive. The peaks of PIGF,PAPP-A Levelsbefore and after PCI in patients with cardiovascular events were significantly higher than thosepatients without cardiovascular events.(5)The follow-up results:During the follow-up period,there were MACE group(8cases),non-MACE group 57 cases,and 5 cases were out of followed.In the MACE group,5 casesappeared that the serum of PlGF and PAPP-A level were significantly increased after 24 hours.2cases appeared only PlGF level was increased significantly.1 case didn’t have both indexsincreased significantly.Conclusion: the peaks of PIGF,PAPP-A before and after PCI is related with cardiovascularevents,two of them could be regarded as risk factors in predicting cardiovascular event in CHDpatients undergoing PCI.