The Correlation Between Pregnancy-Associated Plasma Protein-A And Myocardial Perfusion In Patients With Unstable Angina Pectoris

Objective To observe the relationship between Pregnancy associated plasma protein-A(PAPP-A)levels and the perfusion of coronary microcirculation in patients with unstable angina pectoris(UAP)by quantitative analysis.Patients and Methods Totally 82 patients with unstable angina pectoris received coronary angiography(CAG)was in cluded during June 2006 to December 2007,whom were confirmed UAP,based on ACC / AHA Guidelines for the Management of Patients with Unstable Angina and Non-ST-Segment Elevation Myocardlial Infarction.Serum samples were collected for determining PAPP-A of all the patients immediately at admission.PAPP-A levels were determined by enzyme linked immunosorbent assay(ELISA),hs-CRP levels were determined by immunoturbidimetry assay.The clinical data of all the patients were record:age, gender,hypertension,diabetes,hypercholesteremia,smoking,left ventricular ejection fraction(LVEF),coronary angiography(CAG),TIMI,,high sensitivity C-reactive protein(hs-CRP),creatinine(CR),blood urea nitrogen(BUN),cardiac Triponin T(cTNT),triglyceride(TG),total cholesterol(CliO),high density lipoprotein cholesterol(HDL-C),fasting blood glucose(FBG),creatine kinase (CK),creatine kinase MB(CK-MB).To valuate efficiently the perfusion of coronary microcirculation by CTFC.82 patients were divided into 2 groups: myocardial perfusion slow flow group:CTFC≥30 frames,myocardial perfusion normal group:CTFC＜30 frames.Statistical analysis by SPSS 13.0,Probability values＜0.05 were considered statistics significant.Results The data of age, gender,hypertension,diabetes,hypercholesteremia,smoking,left ventricular ejection fraction(LVEF),coronary angiography(CAG),TIMI,Levels of CRP,CR,BUN,TnT,TG,CHO,HDL-C,FBG,CK,CK-MB were not significantly different between the two groups(P＞0.05).PAPP-A level of myocardial perfusion slow flow group is higher than PAPP-A level of myocardial perfusion normal group significantly(P＜0.01).PAPP-A level was positive significantly related with the myocardial perfusion(r=0.375,P=0.001).Myocardial perfusion In patients with type 2 DM was slower than patients without type 2 DM by the method of CTFC(P＜0.05)Serum PAPP-A levels and CTFC were positive significantly related with FBG(r=0.251,P=0.023;r=0.238,P=0.031)Conclusion The serum PAPP-A levels are elevated in perfusion slow flow group, which serum PAPP-A levels at admission in patients with unstable angina pectoris may reflect myocardial perfusion.PAPP-A level elevating is a strong independent predictor of myocardial perfusion.Myocardial perfusion is associated unstable coronary artery atherosclerotic plaques activity and enhanced local inflammatory state.