{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T17:35:21Z","timestamp":1769103321067,"version":"3.49.0"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2010,7,1]],"date-time":"2010-07-01T00:00:00Z","timestamp":1277942400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Background: The free fraction of pregnancy-associated plasma protein A (FPAPP-A) was found to be the PAPP-A form released to the circulation in acute coronary syndrome (ACS). We estimated the prognostic value of FPAPP-A vs total PAPP-A (TPAPP-A) concentrations in forecasting death and nonfatal myocardial infarction (combined endpoint) in patients with non\u2013ST-elevation ACS.<\/jats:p><jats:p>Methods: We recruited 267 patients hospitalized for symptoms consistent with non\u2013ST-elevation ACS and followed them for 12 months. FPAPP-A, TPAPP-A, C-reactive protein (CRP), and cardiac troponin I (cTnI) were measured at admission; cTnI was also measured at 6\u201312 h and 24 h. Because of the recently shown interaction between PAPP-A and heparin, we excluded patients treated with any heparin preparations before the admission blood sampling.<\/jats:p><jats:p>Results: During the follow-up, 57 (21.3%) patients met the endpoint (22 deaths and 35 nonfatal myocardial infarctions). According to FPAPP-A (&amp;lt;1.27, 1.27\u20131.74, &amp;gt;1.74 mIU\/L) and TPAPP-A (&amp;lt;1.98, 1.98\u20132.99, &amp;gt;2.99 mIU\/L) tertiles, this endpoint was met by 12 (13.5%), 18 (20.2%), 27 (30.3%) (P = 0.02), and 17 (19.1%), 17 (19.1%), 23 (25.8%) (P = 0.54) patients, respectively. After adjusting for age, sex, diabetes, previous myocardial infarction, and ischemic electrocardiogram (ECG) findings, FPAPP-A &amp;gt;1.74 mIU\/L [risk ratio (RR) 2.0; 95% CI 1.0\u20134.1, P = 0.053), increased cTnI, and CRP \u22652.0 mg\/L were independent predictors of an endpoint. The prognostic performance of TPAPP-A was inferior to that of FPAPP-A.<\/jats:p><jats:p>Conclusions: FPAPP-A seems to be superior as a prognostic marker compared to TPAPP-A, giving independent and additive prognostic information when measured at the time of admission in patients hospitalized for non\u2013ST-elevation ACS.<\/jats:p>","DOI":"10.1373\/clinchem.2009.136960","type":"journal-article","created":{"date-parts":[[2010,5,7]],"date-time":"2010-05-07T02:19:48Z","timestamp":1273198788000},"page":"1158-1165","source":"Crossref","is-referenced-by-count":29,"title":["Free vs Total Pregnancy-Associated Plasma Protein A (PAPP-A) as a Predictor of 1-Year Outcome in Patients Presenting with Non\u2013ST-Elevation Acute Coronary Syndrome"],"prefix":"10.1093","volume":"56","author":[{"given":"Juha","family":"Lund","sequence":"first","affiliation":[{"name":"Department of Medicine 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Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kim","family":"Pettersson","sequence":"first","affiliation":[{"name":"Department of Biotechnology, University of Turku, Turku, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liisa-Maria","family":"Voipio-Pulkki","sequence":"first","affiliation":[{"name":"Department of Medicine and"},{"name":"Department of Medicine, Helsinki University Hospital, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2010,7,1]]},"reference":[{"key":"2020022704350245500_R1","doi-asserted-by":"crossref","first-page":"1924","DOI":"10.1161\/01.CIR.0000096054.18485.07","volume":"108","year":"2003","journal-title":"Circulation"},{"key":"2020022704350245500_R2","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1080\/07853890500525883","volume":"38","year":"2006","journal-title":"Ann 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