Pregnancy-associated plasma protein A and copeptin as markers in the early diagnosis of acute coronary syndrome

Objective: To evaluate the combined detection of pregnancy-associated plasma protein A (PAPP-A) and copeptin as a diagnostic marker in patients with acute coronary syndrome (ACS). Methods: Serum levels of PAPP-A, copeptin, creatine kinase isoenzyme MB (CK-MB) and cardiac troponin I (cTnI) were detected within 3 hours after acute chest pain in 120 patients who were suspected of having ACS and in 100 healthy control subjects. Electrocardiograms (ECG) were also performed for each subject. ACS was diagnosed using the current three-part gold standard (clinical manifestation, ECG result, biomarker levels). The sensitivity and selectivity of combined detection of PAPP-A and copeptin for the diagnosis of ACS were evaluated. Results: Serum levels of PAPP-A and copeptin were significantly higher in patients with ACS than in controls (P<0.01). The sensitivity and negative predictive value of combined detection of PAPP-A and copeptin were 96.15% and 98.21%, respectively, both significantly higher than ECG, CK-MB, cTnI, PAPP-A alone, copeptin alone, and cTnI plus ECG (P<0.05). Combined PAPP-A and copeptin detection also gave the highest diagnostic rate of all of these tests (89%). Conclusion: Combined detection of PAPP-A and copeptin is a highly effective tool for the early diagnosis of ACS.