Pregnancy-associated plasma protein A and procalcitonin as markers of myocardial injury in patients with acute coronary syndrome.

Abstract

To evaluate pregnancy-associated plasma protein A (PAPP-A), ischemia-modified albumin (IMA), procalcitonin, and troponin I levels as diagnostic markers of acute coronary syndrome in patients admitted to the emergency department. The serum PAPP-A, IMA, procalcitonin, and troponin I levels were measured in 100 patients with acute coronary syndrome admitted to the emergency department and 100 healthy control subjects. Patients with acute coronary syndrome had significantly greater mean serum PAPP-A (patients, 10 ± 10 mIU/L; control subjects, 6 ± 10 mIU/L; P < 0.001), procalcitonin (patients, 2 ± 10 µg/L; control subjects, 0.4 ± 2 µg/L; P < 0.001), and troponin I levels (patients, 6 ± 8 µg/L; control subjects, 0.2 ± 0.3 µg/L; P < 0.001) than control subjects. There was no difference in mean IMA levels between patients and control subjects. There were no significant correlations between PAPP-A levels and IMA, procalcitonin, or troponin I levels in patients with acute coronary syndrome. The PAPP-A, procalcitonin, and troponin I levels were increased in patients with acute coronary syndrome. Therefore, elevated PAPP-A and procalcitonin levels, in addition to troponin I levels, may be useful markers of myocardial injury on admission to the emergency department.