Pregnancy-associated plasma protein A as a predictor of all-cause mortality and cardiovascular events in patients with chronic kidney disease: a meta-analysis of prospective studies

Yuehua Li; Xv Meng; Chenghui Zhou; Xianliang Zhou

doi:10.5114/aoms.2020.91283

Pregnancy-associated plasma protein A as a predictor of all-cause mortality and cardiovascular events in patients with chronic kidney disease: a meta-analysis of prospective studies

Arch Med Sci. 2019 Dec 31;16(1):8-15. doi: 10.5114/aoms.2020.91283. eCollection 2020.

Authors

Yuehua Li¹, Xv Meng¹, Chenghui Zhou², Xianliang Zhou¹

Affiliations

¹ Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, China.
² Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Abstract

Introduction: The aim of the study was to assess the association of elevated serum pregnancy associated plasma protein A (PAPP-A) and the risk of all-cause mortality, cardiovascular events and mortality due to infection in patients with chronic kidney disease (CKD).

Material and methods: We systematically searched the Medline database up to March 2017. A random effects model was used to pool the relative risks (RRs) and their 95% confidence intervals (CIs). Sensitivity analysis and subgroup analysis were performed to explore the potential sources of heterogeneity.

Results: Six studies involving 2034 subjects were included. The pooled RRs for the risk of all-cause mortality and cardiovascular events were 1.50 (95% CI: 1.17-1.92), 1.26 (95% CI: 0.95-1.69), respectively. Sensitivity analysis by excluding each individual study showed no influence on the main results. Subgroup analysis showed that age, male proportion, follow-up term, and assay methods were not modifiable factors.

Conclusions: Our study suggests that elevated serum PAPP-A is associated with the risk of all-cause mortality in patients with CKD.

Keywords: all-cause mortality; chronic kidney disease; meta-analysis; pregnancy-associated plasma protein A.