- 作者：Olaf Schulz ; Alex ; er B. Postnikov ; Tatiana I. Smolyanova ; Alexey G. Katrukha ; Ingolf Schimke ; Allan S. Jaffe
- 关键词：PAPP-A ; IGF fragments
- 刊名：Clinical Biochemistry
- 出版年：February, 2014
- 年：2014
- 卷：47
- 期：3
- 页码：177-183
- 全文大小：271 K
Objectives
We have previously reported that increases in total pregnancy-associated plasma protein-A (PAPP-A) which are thought to be indicative of vulnerable plaques and thus poor outcomes predict outcomes in patients with stable coronary artery disease. We hypothesized that the determination of CT- and NT-fragments of insulin-like growth factor binding protein 4 (CT- and NT-IGFBP4) which should be indicative of free PAPP-A would result in better performance.Methods
In 229 stable cardiovascular patients with indication for heart catheterization after performance of a stress test and an echocardiogram, CT- and NT-IGFBP4 were measured. Their values were investigated in relation to clinical characteristics, findings of noninvasive investigations, laboratory data and coronary angiography as well as to outcomes after a follow-up of 1094 卤 307 days.
Results
CT-IGFBP4 values were independently predicted by patients with B-type (p = 0.0069) or complex coronary lesions (p = 0.0445). B-type and vulnerable coronary lesions were independently predicted by levels of CT-IGFBP4 鈮?#xA0;a cutoff of 31.55 ng/mL derived from ROC analysis (p = 0.0090 and 0.0480). NT-IGFBP4 was not predictive of coronary characteristics. Both IGFBP4 fragments were strongly dependent on age and renal function and were not predictive of outcomes.
Conclusion
Despite the relation of CT-IGFBP4 to a more severe coronary artery disease, CT- and NT-IGFBP4, in contrast to our report based on total PAPP-A, failed to predict any long-term outcomes in patients with stable cardiovascular disease. Further knowledge about the interaction of the PAPP-A-insulin-like growth factor system is needed to explain values of IGFBP4 fragments in these patients.