Objective: In this study, we aimed to investigate the importance of serum pregnancy associated plasma protein A (PAPP-A) levels as an early marker before an acute myocardial infarction due to a high risk atherosclerotic plaque rupture and the relationship between PAPP-A and insulin like growth factor I (IGF-I).

Materials and Methods: Serum PAPP-A and IGF-I levels were determined in 41 patients diagnosed as ACS and 39 healthy individuals.

Results: P APP-A levels in the patient group was significiantly higher than the control group (p=0.0001). On the other hand, no significiant difference was found between the groups regarding IGF-I levels (p=0.882). A positive, weak, statistically non-significiant corelation was found between PAPP-A and IGF-I levels (r=0.018, p=0.875). A receiver-operating curve (ROC) was plotted to determine the effectiveness of PAPP-A levels in differentiating the patients with acute coronary syndrome from the healthy individuals. The area under the curve was calculated as 0.858 (p=0.0001). Choosing 1.945 mIU/L as the cut-off point, a sensitivity of 85.4% and a spesificity of 82.1% were revealed.

Conclusion: Although our results support that PAPP-A might be a useful marker for the diagnosis of acute coronary syndrome, prospective studies conducted in larger patient groups are required to explain the role of IGF-I and its relation with PAPP-A in acute coronary syndrome.