Plain English Summary
Background and study aims
Acute coronary syndrome (ACS) refers to a group of conditions due to decreased blood flow in the coronary arteries such that part of the heart muscle is unable to function properly or dies. It encompasses a range of sudden heart conditions, including heart attack and unstable angina attack (sudden chest pain). ACS mainly happens due to narrowing of the blood vessels which supply the heart due to a build-up of plaque (a fatty, sticky substance) on the walls of arteries. Treatment for ACS can include surgery to unblock the blood vessels to supply he heart and use of blood thinning medications. Patients who have type 2 diabetes (a condition where the sufferer is unable to control their blood sugar levels properly) are known to have a higher rate of complications than previously healthy patients. Previous studies have shown that that a protein called pregnancy-associated plasma protein-A (PAPP-A) is a potentially important biomarker (natural indicator) of dangerous plaque and inflammation (swelling) in patients with ACS and has been identified in heart plaque. Patients with type 2 diabetes appeared to have high levels of PAPP-A than healthy people of the same age. The aim of this study is to find out whether increased levels of PAPP-A are an indicator of future heart and blood vessel complications after ACS.
Who can participate?
All patients who have been hospitalised for ACS who have had their PAPP-A levels measured.
What does the study involve?
After being admitted to hospital for ACS, participants are treated by cardiologists (heart doctors) as usual, following standard ACS treatment guidelines. Participants attend follow up appointments after 6, 12 and 24 months, where they are interviewed to find out if they have had any heart and blood vessel complications, such as stroke or heart attacks. This is then confirmed by reviewing medical records.
What are the possible benefits and risks of participating?
There are no direct benefits or risks involved to those participating.
Where is the study run from?
The Beijing Friendship Hospital Cardiovascular Center, Capital Medical University (China)
When is the study starting and how long is it expected to run for?
June 2012 to December 2014
Who is funding the study?
Chinese National Science Foundation (China)
Who is the main contact?
Professor Xue-Qiao Zhao
Chinese National Science Foundation (Grant No 81300161)
Pregnancy-associated plasma protein-A is a stronger predictor for adverse cardiovascular outcomes post-acute coronary syndrome in patients with type 2 diabetes mellitus
Pregnancy-associated plasma protein-A (PAPP-A) is predictive for future adverse cardiovascular outcomes in patients with type-2 diabetes (T2DM).
Beijing Friendship Hospital Institutional Review Board, 01/04/2012
Primary study design
Secondary study design
Patient information sheet
Not available in web format, please use the contact details to request a patient information sheet
1. Acute coronary syndrome
2. Type-2 diabetes mellitus (T2DM)
All study participants are enrolled into the study during their ACS hospitalization. During hosptialisation, participants are treated using standard techniques. This may include percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG) and medication, as decided by treating cardiologists following ACS treatment guidelines.
After hospital discharge, study participants are followed by their cardiologists for 24 months. After 6, 12 and 24 months, participants attend follow up visits at which the cardiovascular event rate is recorded.
Primary outcome measures
1. Cardiovascular death rate is assessed by medical record review and confirmed with death certificate at baseline, 6, 12 and 24 months of the 2 years of follow-up
2. Non-fatal MI rate is assessed by patient interview and confirmed by medical record review at baseline, 6, 12 and 24 months of the 2 years of follow-up
3. Non-fatal stroke rate is assessed by patient interview and confirmed by medical record review at baseline, 6, 12 and 24 months of the 2 years of follow-up
Secondary outcome measures
No secondary outcome measures.
Overall trial start date
Overall trial end date
Participant inclusion criteria
1. Confirmed acute coronary syndrome
2. Has PAPP-A measurements
Target number of participants
Participant exclusion criteria
1. Aystemic inflammatory disease or cancer
2. Missing PAPP-A measurements
Recruitment start date
Recruitment end date
Countries of recruitment
Trial participating centre
The Beijing Friendship Hospital Cardiovascular Center, Capital Medical University
95th Yongan Road Xicheng District
Chinese National Science Foundation
83 Shuangqing Road
+86 (0)106 231 7474
National Natural Science Foundation of China
National Science Foundation of China, Natural Science Foundation of China, NSFC
Funding Body Type
Funding Body Subtype
Results and Publications
Publication and dissemination plan
Plans to public study results in the first quarter of 2017.
IPD Sharing plan:
The datasets generated during and/or analysed during the current study are/will be available upon request from Moni Blazej Neradilek (firstname.lastname@example.org)
Intention to publish date
Participant level data
Available on request
Results - basic reporting
2017 results in: https://www.ncbi.nlm.nih.gov/pubmed/28381225