Utility of Placental Growth Factor for Prediction of 30-Day Adverse Event in Emergency Department Population with Non-ST Elevation Acute Coronary Syndrome

Abstract

Background: Placental growth factor (PlGF) belongs to the vascular endothelial growth factor family and seems to be an independent biomarker for plaque disruption, ischemia, and thrombosis. Plasma PlGF is rapidly produced in infarcted myocardial tissue during the acute phase of myocardial infarction. In this study, the relevance of PIGF was analyzed at the admission of patients with acute coronary syndrome (ACS) without ST elevation for the prognosis of fatal outcome after 30 days. Methods: We collected blood samples from 102 ACS patients admitted to the coronary unit with manifesting acute chest pain within the previous 12 hours and measured the levels of PIGF, high-sensitivity C-reactive protein (hsCRP), and cardiac markers: troponin T (cTnT), B-type natriuretic peptide, creatine kinase-MB (CKMB) and CK activity. Results: PlGF, troponin T, and hsCRP levels were significantly higher in non-survivors than in survivors. ROC analysis showed that PIGF had the highest area under ROC curve (AUC, 0.713), but it was not significantly different from AUCs for cTnT and hsCRP. Higher values of PlGF (>13.2 ng/L) pointed towards a higher risk of fatal outcome (HR 2.28; 95 % CI 1.21-4.76; P=0.0125). The multivariable proportional hazards analysis, which had involved other statistically significant markers of relative risk (age and gender), showed that PlGF was an independent prognostic marker (adjusted HR 2.14; 95 % CI 1.08-4.22). Conclusions: These results confirmed that PlGF is an independent biomarker of short-term adverse outcome in patients with ACS without ST elevation and that plaque instability, represented by PlGF elevation, has an important role in the pathogenesis of future coronary events. (Clin. Lab. 2010;56:215-222)