Role of PAPP-A in atherothrombosis: Messages to take home

Abstract

Pregnancy-associated plasma protein-A (PAPP-A), first characterised in pregnancy in the 1970s, is a potentially useful prognostic and diagnostic marker for patients with coronary artery disease [1]. Even among stable and troponin-negative patients, plasma PAPP-A concentrations are directly associated with the risk of an acute coronary syndrome (ACS) [2] and with the number of unstable (and total) coronary plaques [3]. In ACS, raised PAPP-A levels are more sensitive for early diagnosis than CK-MB or troponin T [2,4] and a stronger predictor of adverse events than C-reactive protein [5].