Comparing the value of pregnancy associated Plasma Protein A (PAPP-A) and ischemia modified albumin in the patients with chest pain

Year 2017, , 113 - 123, 01.06.2017

Özgür Tatlı , Yunus Karaca , İsmet Durmuş Sinan Şahin Ahmet Menteşe , Suha Türkmen Abdulkadir Gündüz , Süleyman Türedi

https://doi.org/10.18663/tjcl.292392

Abstract

Aim: To evaluate the diagnostic value of
PAPP-A and CK-MB in early diagnosis of ACS.

Material and Methods: It is a single-center, prospective,
clinical study. There were totally 152 cases. At the end of the study the
levels of troponin-T, CK-MB, PAPP-A and IMA in the different groups were
compared.

Results: There were 13 patients
with STEMI, 53 patients with NSTEMI/UAP and 80 patients with non-specific ECG
findings. When we consider the definitive diagnosis; there were 8 patients with
STEMI, 36 patients with NSTEMI, 23 patients with UAP, 17 patients with SAP and
68 patients with non-coroner chest pain. In our study, the most specific
parameter at the highest sensitivity for the patients with the chest pain
within the first hours (0-2 hour, 2-4 hour) was IMA. (Sensitivity/specificity;
100/30.7, 93.7/52.3 respectively).

Conclusion: According to our
results, PAPP-A and IMA cannot be used as an diagnostic tool like troponin-T
and CK-MB in ACS. Also IMA cannot be used as an ideal screening test in the
diagnosis of ACS during the early period of chest pain.  Still, IMA is more useful diagnostic
biochemical marker than troponin-T, CK-MB and PAPP-A as a screening test in
detecting ACS during the first hours. 

Keywords

PAPP-A, IMA, chest pain, acute coronary syndrome

Göğüs ağrısı olan hastalarda gebelikle ilişkili Plazma Protein A (PAPP-A) ve iskemi modifiye albümin değerinin karşılaştırılması

Abstract

Amaç: AKS’un erken tanısında PAPP-A ve CK-MB’nin tanısal değerinin
belirlenmesidir.

Gereç
ve Yöntemler: Tek merkezli, prospektif, klinik bir çalışma 152 vaka
incelendi. Çalışmanın sonunda troponin-T, CK-MB, PAPP-A ve IMA’nın farklı
gruplardaki düzeyleri kıyaslandı.

Bulgular: 13 hastada STEMI tanısı kondu, 53 hastada NSTEMI/UAP ve 80
hastada non spesifik EKG bulguları mevcuttu. Kesin tanısına göre 8 hastada
STEMI, 36 hastada NSTEMI, 23 hastada UAP ( unstabil njina pektoris), 17 hastada
SAP (stabil anjina pektoris) 68 hastada non koroner göğüs ağrısı mevcuttu.
Göğüs ağrısının ilk saatlerinde (0-2 saat, 2-4 saat) en yüksek sensitivitedeki
en spesifik parametre IMA idi. (Sensitivite/spesifite; 100/30.7, 93.7/52.3).

Sonuçlar: Sonuçlarımıza
göre, PAPP-A ve IMA, AKS'de troponin-T ve CK-MB gibi bir tanı aracı olarak
kullanılamaz. Sonuçlarımız, duyarlılık ve özgüllük özellikleriyle ilgili olarak
IMA, göğüs ağrısı erken döneminde AKS tanısında ideal bir tarama testi olarak
kullanılamaz. Yine de, IMA, ilk saatler boyunca AKS'yi saptamada bir tarama
testi olarak troponin-T, CK-MB ve PAPP-A'ya kıyasla daha yararlı diagnostik biyokimyasal
belirteçtir. Çalışma sonuçlarımız literatürde benzer bir çok araştırmanın
aksine bir sonuç sergilemektedir ve bulguları daha kapsamlı bir dizi çalışma
ile değerlendirilmelidir.

 

Keywords

PAPP-A, IMA, gögüs ağrısı, akut koroner sendrom

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