Profile of Serum Pregnancy-Associated Plasma Protein A after Sustained Subcutaneous Low Molecular Weight Heparin Administration in Patients with Cerebrovascular Diseases

Abstract

To the Editor: Pregnancy-associated plasma protein A (PAPP-A),1 considered a surrogate marker of increased risk of unstable atherosclerosis and its complications (1, 2), is reversibly bound to the surfaces of several cell types because of heparin's effective competition for surface binding (3). Heparins, however, especially low molecular weight heparins (LMWH), are routinely used for the treatment and prevention of thromboembolism. Because of the observation that intravenous administration of LMWH and heparin elicits a rapid increase in serum PAPP-A (4), we investigated the time profile of the effect of subcutaneous LMWH administration on PAPP-A concentration in a cerebrovascular disorder population. Blood samples were collected from 10 patients with ischemic stroke receiving 5000 U of subcutaneous LMWH twice daily (group A) and 10 patients with percutaneous carotid intervention receiving 4375 U heparin intravenously just before stenting (group B). For each patient in group A, the first venous blood sample was drawn after admission. We also collected samples at 3 h after LMWH administration on days 2, 3, …