ABSTRACT
Objective To evaluate the overall prognostic effects of pregnancy-associated plasma protein-A (PAPP-A) in acute coronary syndrome (ACS)through a meta-analysis.Methods Literature was retrieved by formal searching of electronic databases (PubMed,EMBASE,OVID,Web of Knowledge,and the Cochrane Library) and by hand searching of reference lists of related articles.Random effects meta-analysis and relative risk were used to estimate the association between PAPP-A levels and adverse cardiovascular outcomes after ACS as well as preplanned subgroup analyses were conducted to identify the risk-subgroup interactions that could explain the between differences.Results A total of fourteen clinical trials were included in this Meta-analysis which involving 9413 patients.Pooled RR and their 95％ confidence intervals (CIs) for all eligible studies was 1.97 (1.49-2.60),which indicated a prognostic value of PAPP-A in patients with ACS.Differences in study design,measurement of association and duration of follow-up were responsible for the differences in results across the studies.Conclusion Our results suggested that a higher early blood PAPP-A could moderately increase the long-term risk of adverse cardiovascular outcomes and might serve as a valuable prognostic predictor in patients with ACS.