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.
