Key result
Elevated PAPP-A, CRP, BNP and decreased PAB predict early-stage heart failure post-AMI.
Why the study?
The study sought to analyze the predictive value of early measurement of PAPP-A, PAB, CRP, BNP, and other indicators for heart failure after AMI.
Do early measurements of serum PAPP-A, PAB, CRP, and BNP predict heart failure in the early stage of acute myocardial infarction?
Observational (n=200)
No
Do early measurements of serum PAPP-A, PAB, CRP, and BNP predict heart failure in the early stage of acute myocardial infarction?
Combined testing of serum PAPP-A, PAB, CRP, and BNP provides accurate prediction and evaluation of heart failure following acute myocardial infarction.
Early biomarker panels may stratify post-AMI HF risk; hypothesis-generating and requires prospective validation before clinical adoption.
BACKGROUND: The study sought to analyze the predictive value of the early measurement of pregnancy associated plasma protein-A (PAPP-A), prealbumin (PAB), C-reactive protein (CRP), brain natriuretic peptide (BNP), and other indicators of heart failure (HF) after acute myocardial infarction (AMI). METHODS: A total of 200 AMI patients admitted to Wuyi People's Hospital from November 1, 2019 to October 31, 2020 were continuously enrolled as the research objects and divided into a HF group (Killip class II or above, n=94) and HF-free group (Killip class I or below, n=106) according to the Killip Classification for Heart Function. RESULTS: The age, creatine kinase-myocardial band (CK-MB), PAPP-A, CRP, suppression of tumorigenicity 2 (ST2), BNP, aldosterone (ALD), and left ventricular end-diastolic diameter (LVEDD) of the HF group were all significantly higher than those of the HF-free group, while the PAB and left ventricular ejection fraction (LVEF) were significantly lower (P<0.05). The PAPP-A, CRP, and BNP of HF patients increased as the Killip class increased, while the PAB decreased progressively (P<0.05). After including the statistically significant single factors in a multivariate logistic regression analysis, it was found that PAPP-A, PAB, CRP, and BNP were the independent influencing factors causing HF in the early stage of AMI; and the diagnostic efficacy of HF in the early stage of AMI (from high to low) was combined test, PAPP-A, PAB, BNP and CRP. CONCLUSIONS: Serum PAPP-A, PAB, CRP and BNP levels are the independent influencing factors of HF after AMI, but comprehensive tests of clinical indicators, including PAPP-A, PAB, CRP, and BNP, are more accurate at predicting and evaluating HF and can be used to guide clinical decisions.
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Yang et al. (2022) conducted an observational in Acute myocardial infarction (n=200). Serum PAPP-A, PAB, CRP, and BNP levels vs. HF-free group (Killip class I or below) was evaluated on Heart failure in the early stage of acute myocardial infarction (p=<0.05). Elevated serum PAPP-A, CRP, and BNP, and decreased PAB levels were independent predictors of early-stage heart failure after acute myocardial infarction (P<0.05).
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