“These results are remarkable and potentially of great clinical significance,” said Paula Southwick, PhD, co-author and group manager of Clinical Research at Beckman Coulter, the company that developed the blood test. “Emergency department physicians and cardiologists do not want to discharge patients who are at imminent risk of heart attack or death. This test predicted cardiac events that were missed by other blood tests and traditional risk factors. The profound prognostic value of this test may assist in discerning patients who require hospital admission from those who may be managed less aggressively in an outpatient environment, potentially saving patient lives and at the same time reducing healthcare costs.”
PAPP-A is an enzyme — first identified in the placenta of pregnant women but also found at lower concentration in non-pregnant women and men — associated with coronary plaque destabilization or rupture. Plaque rupture and the ensuing thrombosis which occurs at the site of rupture is the leading cause of heart attack. While clinical models for the prediction of CV mortality after ACS are currently in use, prediction of recurrent ischemic events with high discrimination has been difficult. The cPAPP-A test appears to address this major unmet patient need and would provide physicians with a blood test to predict these events.
Principal investigators David A. Morrow, MD, MPH, and Marc Bonaca, MD, MPH, of Brigham and Women’s Hospital, TIMI Study Group, Cardiovascular Division, Harvard Medical School, concluded that “our findings add to emerging evidence supporting cPAPP-A as a candidate prognostic marker of recurrent coronary events, and support continued investigation. Hospitalization for recurrent events occurs in up to one in every five patients, but prediction of these events has been difficult. In this context, our findings with cPAPP-A are intriguing for its potential role as a clinical risk predictor.”
1. Bonaca MP, Scirica BM, Sabatine MS, Jarolim P, Murphy SA, Chamberlin JS, Rhodes DW, Southwick PC, Braunwald E, Morrow DA. Prospective evaluation of pregnancy-associated plasma protein-a (PAPP-A) and outcomes in patients with acute coronary syndromes. J Am Coll Cardiol 60:332-338 (July 24, 2012).
*The cPAPP-A assay is for research use only. Not for use in diagnostic procedures.