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Evaluation of Serum Pregnancy Associated Plasma Protein-A & Plasma D-Dimer in Acute Coronary Syndrome
Gautam Nichenametla1, Vivian Samuel Thomas2
1Post Graduate, Department of Biochemistry, J.J.M. Medical College , Davangere, Karnataka, India .
Insights
Pregnancy Associated Plasma Protein-A (PAPP-A) and D-Dimer show promise in diagnosing acute coronary syndrome (ACS), outperforming traditional CK-MB markers. These markers reflect plaque instability and thrombosis, aiding early ACS diagnosis.
Area of Science:
- Cardiology
- Biomarker Research
- Emergency Medicine
Background:
- Acute coronary syndrome (ACS) is a leading cause of emergency department visits.
- Current diagnostic tools like ECG and cardiac enzymes can be unreliable, delaying treatment.
- Newer biomarkers reflecting ACS pathophysiology are needed for accurate early diagnosis.
Purpose of the Study:
- To evaluate Pregnancy Associated Plasma Protein-A (PAPP-A) and D-Dimer for diagnosing ACS.
- To compare the diagnostic competence of PAPP-A and D-Dimer against CK-MB.
- To assess the role of High Sensitive C-Reactive Protein (hs-CRP) in ACS.
Main Methods:
- Study included 50 ACS patients and 50 healthy controls.
- Serum PAPP-A measured via Enzyme Linked Immunosorbent Assay (ELISA).
- D-Dimer and hs-CRP levels determined using Latex Turbidimetry.
Main Results:
- PAPP-A and D-Dimer showed statistically significant differences between ACS patients and controls (p < 0.001).
- CK-MB did not show a significant difference (p = 0.09).
- A statistically significant positive correlation was observed among the tested parameters.
Conclusions:
- PAPP-A, a marker of plaque instability, is elevated in ACS.
- D-Dimer, indicating ongoing thrombosis, is also raised in ACS.
- PAPP-A and D-Dimer can serve as valuable diagnostic markers for acute coronary syndrome.
Introduction:
Acute coronary syndrome (ACS), a spectrum comprising unstable angina pectoris, ST Elevated Myocardial Infarction (STEMI) & Non ST Elevated Myocardial Infarction (NSTEMI) is the major cause of presentation in Emergency Department today. Though ECG and cardiac enzymes are used for diagnosis, they mislead the diagnosis sometimes and delay in treatment initiation. This leads us to search certain new parameters which reflect the pathophysiology of ACS. Markers of plaque stability like Pregnancy Associated Plasma Protein-A and D-Dimer, a marker of ongoing thrombosis are found to be better markers in early diagnosis.
Aim:
To evaluate the diagnostic competence of PAPP-A and D-Dimer in acute coronary syndrome over CK-MB and to compare with the inflammatory marker High Sensitive C-Reactive Protein (hs-CRP) which is associated with atherosclerosis.
Materials And Methods:
Fifty patients presenting with acute onset of chest pain to Emergency Department with or without ECG changes served as cases and 50 healthy people served as controls. Serum PAPP-A is measured by Enzyme Linked Immunosorbent Assay (ELISA), D-Dimer and hs-CRP by using Latex Turbidimetry method.
Results:
A statistical significant difference of PAPP-A and D-Dimer was noted between the ACS and controls (p < 0.001) whereas CK-MB shows no much difference (p 0.09). Statistically significant positive correlation is noted between parameters.
Conclusion:
PAPP-A marker of plaque instability and D-Dimer marker of ongoing thrombosis are raised in acute coronary syndrome and thus can be considered as one of the marker in ACS for diagnosis.
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