Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2017, vol. 26, nr 3, May-June, p. 467–473

doi: 10.17219/acem/62225

Publication type: original article

Language: English

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A coronary proatherosclerotic marker: Pregnancy-associated plasma protein A and its association with coronary calcium score and carotid intima-media thickness

Abdullah Guven1,A,B,C,D,E,F, Bora Demircelik2,A,B,C,D,E, Ozgul Malcok Gurel3,B,C, Okan Er4,A,D,F, Halil Ibrahim Aydin5,B, Alper Bozkurt6,B,C,E

1 Department of Cardiology, Aydin State Hospital, Aydin, Turkey

2 Department of Cardiology, Hopa State Hospital, Artvin, Turkey

3 Department of Cardiology, Susehri State Hospital, Sivas, Turkey

4 Department of Cardiology, Denizli State Hospital, Denizli, Turkey

5 Department of Cardiology, Erzurum State Hospital, Erzurum, Turkey

6 Department of Radiology, Yeni Yuzuncu Yıl Hospital, Ankara, Turkey

Abstract

Background. Atherosclerosis, a chronic inflammatory disorder of the arteries, is responsible for the greatest number of deaths in westernized societies, with numbers increasing at a marked rate in developing countries. Coronary calcium score (CCS), carotid intima-media thickness (CIMT) and pregnancy-associated plasma protein A (PAPP-A) are predictors for the development of atherosclerosis.
Objectives. This study was aimed to investigate the relationship between CCS, CIMT and PAPP-A for earlier diagnosis of atherosclerosis.
Material and Methods. A total of 99 patients were included in the study. Coronary computerized tomography (CT) angiography was performed on all patients. The calcium scoring technique was performed using a sequential scanning mode. CIMT measurement was done through the area 1 cm distal of the bulbus arteriosus with carotid Doppler ultrasound. PAPP-A values were analyzed by double immunoenzymatic technique.
Results. Out of 99 patients, 63 were found with coronary atherosclerosis using multislice computed tomography (MSCT) coronary angiography. When the cut-off point for CCS was taken to be 0.40, the sensitivity of this parameter was 97% and its specificity was 68.3%. When the cut-off point for CIMT was taken to be 0.60, the sensitivity and the specificity of these parameters were 75.0% and 87.3%, respectively, for the right measurements and 75.0% and 79.4%, respectively, for the left measurements.
Conclusion. This data support the conclusion that PAPP-A, like CCS and CIMT, is a parameter that can be used to detect subclinical atherosclerosis.

Key words

subclinical atherosclerosis, coronary calcium score, carotid intima-media thickness, pregnancy-associated plasma protein A

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