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SMJ // Article

Original Article

Placental Growth Factor as Short-Term Predicting Biomarker in Acute Coronary Syndrome Patients with Non-ST Elevation Myocardial Infarction

Authors: Mirjana Marković, MSc, Svetlana Ignjatović, PhD, Marijana Dajak MSc, Nada Majkić-Singh, PhD

Abstract

Objectives: The relevance of placental growth factor was analyzed at the admission of patients with acute coronary syndrome (ACS) without ST elevation in prognosis of fatal outcome after 30 days.


Methods: We collected blood samples from 102 ACS patients admitted to the coronary unit with acute chest pain manifesting within the last 12 hours.


Results: In all 102 admitted patients, higher values of placental growth factor (PLGF; >13.2 ng/L, average value) indicated a higher risk of fatal outcome (hazard ratio [HR] 2.28, 95% confidence interval [CI] 1.21- 4.76, P = 0.0125). PLGF is an important independent prognostic marker (adjusted HR 2.35, 95% CI 1.98–4.61, P = 0.1338), and this was shown in a multiparameter model, which involved other statistically important markers of relative risk (age >65, gender, and estimated glomerular filtration rate [eGFR]).


Conclusion: PLGF levels measured at 12 hours of symptom onset and 30 days later may independently predict fatal outcome in patients with ACS without ST elevation.

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References

1. Tadros GM, McConnell TR, Wood GC, et al. Clinical predictors of 30-day cardiac events in patients with acute coronary syndrome at a community hospital. South Med J 2003;96:1113–1120.
 
2. Jaffe AS, Babuin L, Apple FS. Biomarkers in acute cardiac disease: the present and the future [Review]. J Am Coll Cardiol 2006;48:1–11.
 
3. Mitchell AM, Brown MD, Menown IB, et al. Novel protein markers of acute coronary syndrome complications in low-risk outpatients: a systematic review of potential use in the emergency department. Clin Chem 2005;51:2005–2012.
 
4. Vasan RS. Biomarkers of cardiovascular disease: molecular basis and practical considerations [Review]. Circulation 2006;113:2335–2362.
 
5. Thygesen K, Alpert JS, White HD; Joint ESC/ACCF/AHA/WHF Task Force for the Redefinition of Myocardial Infarction. Universal definition of myocardial infarction. Eur Heart J 2007;28:2525–2538.
 
6. Apple FS, Wu AH, Mair J, et al. Future biomarkers for detection of ischemia and risk stratification in acute coronary syndrome [Review]. Clin Chem 2005;51:810–824.
 
7. Iwama H, Uemura S, Naya N, et al. Cardiac expression of placental growth factor predicts the improvement of chronic phase left ventricular function in patients with acute myocardial infarction. J Am Coll Cardiol 2006;47:1559–1567.
 
8. Apple FS, Smith SW, Pearce LA, et al. Assessment of the multiple-biomarker approach for diagnosis of myocardial infarction in patients presenting with symptoms suggestive of acute coronary syndrome. Clin Chem 2009;55:93–100.
 
9. Luttun A, Tjwa M, Moons L, et al. Revascularization of ischemic tissues by PlGF treatment, and inhibition of tumor angiogenesis, arthritis and atherosclerosis by anti-Flt1. Nat Med 2002;8:831–840.
 
10. Heeschen C, Dimmeler S, Fichtlscherer S, et al; CAPTURE Investigators. Prognostic value of placental growth factor in patients with acute chest pain. JAMA 2004;291:435–441.
 
11. Lenderink T, Heeschen C, Fichtlscherer S, et al. Elevated placental growth factor levels are associated with adverse outcomes at four-year follow-up in patients with acute coronary syndromes. J Am Coll Cardiol 2006;47:307–311.
 
12. Apple FS, Pearce LA, Chung A, et al. Multiple biomarker use for detection of adverse events in patients presenting with symptoms suggestive of acute coronary syndrome. Clin Chem 2007;53:874–881.
 
13. Rashidi A, Ghanbarian A, Azizi F, et al. Is chronic kidney disease comparable to diabetes as a coronary artery disease risk factor? South Med J 2007;100:20–26.
 
14. Morrow DA, Cannon CP, Jesse RL; National Academy of Clinical Biochemistry. National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines: clinical characteristics and utilization of biochemical markers in acute coronary syndromes. Clin Chem 2007;53:552–574.
 
15. Martinez-Rumayor A, Januzzi JL Jr. Non-ST segment elevation acute coronary syndromes: a comprehensive review. South Med J 2006;99:1109–1110.
 
16. Dajak M, Marković M, Ignjatović S, Majkić-Singh N. Evaluation of quantikine ELISA test for the measurement of placental growth factor. Jugoslov Med Bio chem 2006;25:4–488.
 
17. Stevens LA, Coresh J, Greene T, et al. Assessing kidney function—measured and estimated glomerular filtration rate. New Eng J Med 2006;354:2473–2483.
 
18. Thomas L, Huber AR. Renal function—estimation of glomerular filtration rate. Clin Chem Lab Med 2006;44:1295–1302.
 
19. Stary HC, Chandler AB, Dinsmore RE, et al. A definition of advanced types of atherosclerotic lesions and a histological classification of atherosclerosis. A report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. Circulation 1995;92:1355–1374.
 
20. Koenig W, Khuseyinova N. Biomarkers of atherosclerotic plaque instability and rupture. Arterioscler Thromb Vasc Biol 2007;27:15–26.
 
21. Armstrong EJ, Morrow DA, Sabatine MS. Inflammatory biomarkers in acute coronary syndromes: part I: introduction and cytokines. Circulation 2006;113:e72–e75.
 
22. Persico MG, Vincenti V, DiPalma. Structure, expression and receptor-binding properties of placenta growth factor (PlGF). Curr Top Microbiol Immunol 1999;237:31–40.
 
23. Athanassiades A, Lala PK. Role of placenta growth factor (PIGF) in human extravillous trophoblast proliferation, migration and invasiveness. Placenta 1998;19:465–473.
 
24. Cao Y, Ji WR, Qi P, et al. Placenta growth factor: identification and characterization of a novel isoform generated by RNA alternative splicing. Biochem Biophys Res Commun 1997;235:493–498.
 
25. Hauser S, Weich HA. A heparin-binding form of placenta growth factor (PlGF-2) is expressed in human umbilical vein endothelial cells and in placenta. Growth Factors 1993;9:259–268.
 
26. Failla CM, Odorisio T, Cianfarani F, et al. Placenta growth factor is induced in human keratinocytes during wound healing. J Invest Dermatol 2000;115:388–395.
 
27. Tordjman R, Delaire S, Plouët J, et al. Erythroblasts are a source of angiogenic factors. Blood 2001;97:1968–1974.
 
28. Bottomley MJ, Webb NJ, Watson CJ, et al. Placenta growth factor (PlGF) induces vascular endothelial growth factor (VEGF) secretion from mononuclear cells and is co-expressed with VEGF in synovial fluid. Clin Exp Immunol 2000;119:182–188.
 
29. Autiero M, Luttun A, Tjwa M, et al. Placental growth factor and its receptor, vascular endothelial growth factor receptor-1: novel targets for stimulation of ischemic tissue revascularization and inhibition of angiogenic and inflammatory disorders. J Thromb Haemost 2003;1:1356–1370.
 
30. Keshet E. Preventing pathological regression of blood vessels. J Clin Invest 2003;112:27–29.
 
31. Wu AH. Markers for early detection of cardiac diseases. Scand J Clin Lab Invest Suppl 2005;240:112–121.
 
32. Cassidy A, Chiuve SE, Manson JE, et al. Potential role for plasma placental growth factor in predicting coronary heart disease risk in women. Arterioscler Thromb Vasc Biol 2009;29:134–139.
 
33. Hennekens CH. Risk factors for coronary heart disease in women. Cardiol Clin 1998;16:1–8.
 
34. Milner KA, Funk M, Arnold A, et al. Typical symptoms are predictive of acute coronary syndromes in women. Am Heart J 2002;143:283–288.
 
35. Canto JG, Goldberg RJ, Hand MM, et al. Symptom presentation of women with acute coronary syndromes: myth vs reality. Arch Intern Med 2007;167:2405–2413.
 
36. Levey AS, Bosch JP, Lewis JB, et al. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 1999;130:461–470.
 
37. National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 2002;39(2 Suppl 1):S1–S266.