Assessment Of The Relationship Between Pregnancy-associated Protein A And The Severity Of Coronary Artery Disease In Patients With Coronary Heart Disease By Different Coronary Artery Scoring Methods

Objective: To investigate the relationship between pregnancy-associated protein A(PAPP-A)and the severity of coronary artery disease by different coronary artery scoring methods.Methods:We included a total of 151 patients with acute coronary syndrome who were hospitalized in the Shengjing Hospital of China Medical University and divided into three groups:51patients were diagnosed with AMI and 49 patients with unstable angina pectorisand and 51 patients with stable angina pectoris.We collected the general data and clinical laboratory indicators of patients,and used ELISA to determine the level of serum PAPP-A.All patients were assessed by leaman score,gensini score,ACC/AHA score and syntax score according to the results of coronary angiography.Spearman correlation was used to analyze the correlation between PAPP-A and each score.The subjects were divided into mild to moderate coronary artery disease group(gensini1-59,n=104)and severe coronary artery disease group(gensini 60,n=47)according to the best papp-a-related scoring method.Multivariate Logistic regression was used to analyze the risk factors of coronary artery stenosis severity.ROC curve was used to evaluate the value of PAPP-A in predicting the severity of coronary artery disease.Results:The median levels of leaman score,gensini score,ACC/AHA score,syntax score and PAPP-A in UA group and AMI group were all higher than those in SAP group(P<0.05).There was no significant difference between UA group and AMI group.PAPP-A was positively correlated with leaman score,gensini score,ACC/AHA score and syntax scores(r=0.824,P<0.001,r=0.900,P<0.001,r=0.789,P<0.001,r=0.870,P<0.001).Correlations were compared: gensini score>syntax score>leaman score>ACC/AHA score.The PAPP-A level in the severe coronary artery disease group was higher than that in the mild and moderate group [88.57(75.61,103.98)mIU/L vs.41.92(28.44,55.44)mIU/L,P<0.001].PAPP-A is a risk factor for assessing the severity of coronary artery disease(OR=1.138,P=0.000,95%CI: 1.088~1.191).The area under the ROC curve for PAPP-A diagnosis of severe coronary artery disease was 0.956(95%CI: 0.928,0.983,P<0.05),and the sensitivity and specificity were 0.872 and 0.875 when the critical value was66.75mIU/L.Conclusion: PAPP-A is positively correlated with the severity of coronary artery disease.The correlation between PAPP-A and gensini score was the best.When PAPP-A > 66.75mIU/L,it was considered that patients had the possibility of severe coronary lesions.