Abstract 3886: High Serum Level of Pregnancy Associated Plasma Protein A is a Risk Factor of Patients With Heart Failure
Background Previous study has been shown the local cardiac insulin-like growth factor (IGF) systems were involved in progression of left ventricular dysfunction. Pregnancy Associated Plasma Protein A (PAPP-A) is emerging as a critical determinant of growth and development through its ability to ploteolyze IGF binding proteins and then regulate IGF bioavailability in local environment. Recently, it has been reported PAPP-A synthesis related to various pathophysiologies; wound healing, progression of atherosclerosis and coronary artery diseases. However the clinical significance of serum PAPP-A in CHF has not been examined. Therefore, the aim of this study was to examine whether PAPP-A is correlated with the severity of CHF and can predict clinical outcomes in patients with CHF.
Methods and Results Serum PAPP-A levels were measured in 182 patients with heart failure and 20 control subjects. Serum PAPP-A levels were higher in patients with CHF 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±698 days. Serum PAPP-A levels were higher in patients with cardiac events than in event-free patients. Patients were divided into 4 groups on the basis of PAPP-A level. Cox proportional hazards analysis and Kaplan-Meier analysis revealed that the fourth quartile was associated with the greatest risk for cardiac events.
Conclusion Serum PAPP-A level was related to the severity of CHF and associated with a high risk for adverse cardiac events in patients.