- 作者：Akira ; Funayama MD ; Tetsuro ; Shishido MD ; PhD ; ; ; tshishid@med.id.yamagata-u.ac.jp ; Shunsuke ; Netsu MD ; Mitsunori ; Ishino MD ; Toshiki ; Sasaki MD ; PhD ; Shigehiko ; Katoh MD ; PhD ; Hiroki ; Takahashi MD ; PhD ; Takanori ; Arimoto MD ; PhD ; Takuya ; Miyamoto MD ; PhD ; Joji ; Nitobe MD ; PhD ; Tetsu ; Watanabe MD ; PhD ; Isao ; Kubota MD ; PhD
- 关键词：Heart failure ; risk stratification ; biomarker ; insulin-like growth factors
- 刊名：Journal of Cardiac Failure
- 出版年：2011
- 出版时间：October 2011
- 年：2011
- 卷：17
- 期：10
- 页码：819-826
- 全文大小：296 K
Background
Pregnancy-associated plasma protein A (PAPP-A) proteolyzes insulin-like growth factor (IGF)¨Cbinding proteins and thus increases IGF-1 bioactivity. PAPP-A has been reported to be involved in various pathophysiologic abnormalities; however, the clinical significance of PAPP-A has not been examined in cases of heart failure (HF). We hypothesized that PAPP-A levels might be correlated with the severity of HF.Methods and Results
PAPP-A and B-type natriuretic peptide (BNP) levels were measured in 262 subjects (182 HF patients and 80 control subjects). PAPP-A levels were higher in patients with HF than in control subjects and increased with advancing New York Heart Association functional class. There were 53 cardiac events during a mean follow-up period of 796 days. PAPP-A levels were higher in patients with cardiac events than in event-free patients. Patients were divided into 3 groups on the basis of their PAPP-A and BNP levels. Kaplan-Meier analysis demonstrated that the group with both high BNP with high PAPP-A had a significantly higher cardiac event rate than other groups.
Conclusions
Serum PAPP-A levels were related to the severity of HF and associated with a high risk for adverse cardiac events in HF patients, suggesting that PAPP-A might be involved in the pathogenesis of HF.