Diagnostic Test of Serum Pregnancy-Associated Plasma Protein-A Level as Biomarker for Early Diagnosis of Acute Myocardial Infarction

Authors

  • Novida Dwi Astuti Sebelas Maret University
  • JB. Suparyatmo Sebelas Maret University
  • Amiroh Kurniati Department of Clinical Pathology Sebelas Maret University

DOI:

https://doi.org/10.24293/ijcpml.v26i3.1578

Keywords:

PAPP-A, acute coronary syndrome, acute myocardial infarction

Abstract

Acute coronary syndrome is the primary cause of death from heart disease worldwide. This syndrome is caused by ruptured/eroded coronary atherosclerotic plaque, resulting in partial/total occlusion of thrombosis. It is necessary to find novel cardiac biomarkers for the identification of plaque progression before ischemic and myocardial necrosis events. Pregnancy Associated Plasma Protein-A (PAPP-A) is an atherosclerotic mediator proven to be a biomarker for plaque instability. This study aimed to determine the performance of serum PAPP-A as a biomarker for the early diagnosis of AMI. This research was an analytical observational study with a cross-sectional approach. Serum PAPP-A was measured using enzyme-linked immunosorbent assay in 82 new patients. They had ACS and were admitted to the emergency installation of Dr. Moewardi Hospital in Surakarta in August-September 2019. The subjects were grouped into the AMI group (NSTEMI and STEMI) consisting of 49(59.8%) subjects and non-AMI (UAP) group composed of 33(40.2%) subjects based on ACS diagnostic criteria of PERKI 2018. Receiver Operator Characteristic (ROC) curve analysis showed that PAPP-A was a good discriminator between AMI and non-AMI patients. The area under the curve was 0.968, 95% CI (0.932–1.004), with a sensitivity of 91.8% and specificity of 90.9% (p< 0.05). The cut-off value from the ROC curve was 2,526 ng/mL. Serum PAPP-A level has excellent performance as a biomarker for early diagnosis of AMI. It can also function as a screening instrument for the identification of UAP cases developing into AMI.

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Author Biographies

Novida Dwi Astuti, Sebelas Maret University

Department of Clinical Pathology Sebelas Maret University

JB. Suparyatmo, Sebelas Maret University

Department of Clinical Pathology Sebelas Maret University

Amiroh Kurniati, Department of Clinical Pathology Sebelas Maret University

Department of Clinical Pathology Sebelas Maret University

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Submitted

2019-11-14

Accepted

2020-02-13

Published

2020-09-30

How to Cite

[1]
Astuti, N.D., Suparyatmo, J. and Kurniati, A. 2020. Diagnostic Test of Serum Pregnancy-Associated Plasma Protein-A Level as Biomarker for Early Diagnosis of Acute Myocardial Infarction. INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY. 26, 3 (Sep. 2020), 297–302. DOI:https://doi.org/10.24293/ijcpml.v26i3.1578.

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