Clinical Chemistry
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Clinical Chemistry 55: 1214-1217, 2009. First published March 26, 2009; 10.1373/clinchem.2008.108738
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
clinchem.2008.108738v1
55/6/1214    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Google Scholar
Right arrow Articles by Tertti, R.
Right arrow Articles by Pettersson, K.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Tertti, R.
Right arrow Articles by Pettersson, K.
(Clinical Chemistry. 2009;55:1214-1217.)
© 2009 American Association for Clinical Chemistry, Inc.

Brief Communications

Intravenous Administration of Low Molecular Weight and Unfractionated Heparin Elicits a Rapid Increase in Serum Pregnancy-Associated Plasma Protein A

Risto Tertti1,a,1, Saara Wittfooth2,1, Pekka Porela1, K.E. Airaksinen1, Kaj Metsärinne1 and Kim Pettersson2

1 Department of Internal Medicine, Turku University Hospital, Turku, Finland;2 Department of Biotechnology, University of Turku, Turku, Finland

aaddress correspondence to this author at: Department of Internal Medicine, Turku University Hospital, 20521 Turku, Finland. Fax +358-2-3133149; e-mail risto.tertti{at}tyks.fi.


Abstract

Background: Pregnancy-associated plasma protein A (PAPP-A) has been suggested as a useful diagnostic and prognostic marker in acute coronary syndromes. Because low molecular weight heparin (LMWH) and unfractionated heparin (UFH) are commonly used in these cases, we analyzed the effects of intravenous administration of these heparins on serum PAPP-A concentrations.

Methods: Serum concentrations of total and free PAPP-A were analyzed in 14 patients on chronic hemodialysis and in 10 coronary angiography patients. Ten of the dialysis patients received standard LMWH anticoagulation at the start of dialysis, and 4 were treated with a heparin-free method. Two of the patients on heparin-free hemodialysis received a reduced LMWH bolus 2 h after the start of dialysis. All angiography patients received UFH at the start of the procedure, and 1 patient received 2 extra boluses of UFH. Serum PAPP-A concentrations were analyzed before and during the dialysis session and during the coronary angiography examination.

Results: A rapid increase in total PAPP-A (median, 25-fold) was seen in all patients within 5 min of administration for both LMWH and UFH boluses. This response was due to an increase in free PAPP-A in the serum. PAPP-A did not increase significantly in the patients who underwent heparin-free hemodialysis. Repeated heparin boluses induced a new PAPP-A release. In vitro addition of heparins to samples of whole blood did not increase PAPP-A concentrations.

Conclusions: Intravenous administration of heparin induces an intense and rapid increase in free PAPP-A in the serum. We recommend that this effect be considered when PAPP-A is assessed as a biomarker in acute coronary syndromes.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2009 by the American Association for Clinical Chemistry.