Prostate specific antigen levels after acute myocardial infarction
Prostate Specific Antigen (PSA), a member of kallikrein family, is a specific serine protease of prostatic tissue. In some case reports, changes in PSA levels after acute myocardial infarction (AMI) have been reported. In this study we evaluated variations in PSA levels post-AMI. Twenty-six male patients who had PSA levels within reference limits were included in the study. The diagnosis of AMI was confirmed by clinical findings, ECG (electrocardiogram) and cardiac marker studies. Serum total PSA (tPSA) and free PSA (fPSA) levels were measured at days 0 (day of admission), 1, 2 and 3 after AMI. PSA/albumin ratio was also calculated in order to evaluate the effect of dilution. A statistical analysis of the results of all patients revealed significant decrease in tPSA levels and tPSA/Albumin ratio at day 2 when compared to days 0 and 3, which showed a similar pattern. Changes of fPSA and fPSA/ Albumin ratio according to days were not found significant. In only four patients we found increased levels of tPSA and increased fPSA levels in three of them. These patients displayed severe problems such as renal failure, cardiac failure, ventricular aneurysm and cerebral ischemia due to cardiac arrest. The lower tPSA levels on day 2 suggest that tPSA can be eliminated rapidly from the circulation on days 1 and 2, probably through the formation of complexes of tPSA with acute phase proteins.
- Antman E, Bassand J-P, Klein W, Ohman M, Sendon JLL, Ryden L et al. (2000) The Joint European Society of Cardiology/American College of Cardiology Committee.
- Alpert JS, Thygesen K, Antman E, Bassand JP (2000) Myocardial Infarction Redefined - a Consensus Document of The Joint European Society of Cardiology/American College of Cardiology Committee for the Redefinition of Myocardial Infarction. J Am Coll Cardiol 36: 959-969.
- Berent R, Auer J, Porodko M, Lamm G, Weber T, Wimmer E et al. (2006) Influence of cardiopulmonary resuscitation on levels of tumour markers. Eur J Cancer Care (Engl) 15: 252-256.
- Birkenmeier G, Struck F, Gebhardt R (1999) Clearance mechanism of prostate specific antigen and its complexes wıth α2-macroglobulin and α1-antichymotrypsin. J Urol 162: 897-901.
- Bjork T, Ljungberg B, Piironen T, Abrahamsson PA, Pettersson K, Cockett AT, Lilja H (1998) Rapid exponential eliminatıon of free prostate specıfıc antigen contrasts the slow, capacıty limited elmination of PSA complexed to alpha1-antichymotrypsın from serum. Urology 51: 57-62.
- Charlesworth MC, Young CY, Mıller VM, Tındall DJ (1999) Kininogenase activity of prostate derived human glandular kallikrein (hk2) purified from seminal fluid. J Androl 20: 220-229.
- Coker C, Sherwood RA, Crayford T, Saadeh F, Mulvin D, Brakenbury E, Coptcoat MJ (1997) Ischemic damage to the prostate during cardiac surgery: A clinical model. The Prostate 32: 85-88.
- Crook M, Preston K, Lancaster I (1997) Serum prostatic specific-antigen concentrations in acute myocardial infarction (Letter). Clin Chem 43: 1670.
- Koller-Strametz J, Fritzer M, Gwechenberger M, Geppert A, Heinz G, Haumer M et al. (2000) Elevation of prostate-specific markers after cardiopulmonary resuscitation. Circulation 102: 290-293.
- Marcondes S, Antunes E (2005) The plasma and tissue kininogen-kallikrein-kinin system: role in the cardiovascular system. Curr Med Chem-Cardiovasc Hematol Agents 3: 33-34.
- Messadi-Laribi E, Griol-Charhbili G, Gaies E, Vincent MP, Heudes D, Meneton P et al. (2008) Cardioprotection and kallikrein-kinin system in acute myocardial ischemia in mice. Clin Exp Pharmacol Physiol 35: 489-493.
- Oesterling JE (1991) Prostate Specific Antigen: A critical assessment of the most useful tumor marker for adenocarcinoma of the prostate (Abstract). J Urol 145: 907-923.
- Otto A, Bar J, Birkenmeier G (1998) Prostate-specific antigen forms complexes with human alpha 2 macroglobulin receptor/LDL receptor related protein. J Urol 159: 297-303.
- Ozcan T, Bozlu M, Muslu N, Gozukara KH, Seyis S, Akcay B (2009) Elevation of the serum total and free prostate specific antigen levels after stent implantation in patients with coronary artery disease. Swiss Med Wkly 139: 672-675.
- Parlaktas BS, Naseri E, Uluocak N, Elalmış AO, Erdemir F, Etikan I (2006) Comparison of the effects of on-pump versus off-pump coronary artery bypass surgery on serum prostate-specific antigen levels. Int J Urol 13: 234-237.
- Patane S, Marte F (2009a) Prostate-specific antigen and acute myocardial infarction: a possible new intriguing scenario. Int J Cardiol 134: e147-e149.
- Patane S, Marte F (2009b) Prostate-specific antigen kallikrein: from prostate cancer to cardiovascular system. Eur Heart J 30: 1169-1170.
- Patane S, Marte F (2010) Paroxysmal ventricular tachycardia and paroxysmal atrial fibrillation associated with subclinical hyperthyroidism, chronic renal failure and elevation of prostate-specific antigen during acute myocardial infarction (Letter). Int J Cardiol 138: e44-e46.
- Patane S, Marte F (2011) Prostate-specific antigen kallikrein and acute myocardial infarction: Where we are. Where are we going? Int J Cardiol 146: e20-e22.
- Patane S, Marte F, Bella GD, Ciccarello G (2009) Changing axis deviation, paroxysmal atrial fibrillation and elevation of prostate-specific antigen during acute myocardial infarction. (Letter). Int J Cardiol 137: e37-e40.
- Patane S, Marte F, Sturiale M, Grassi R, Patane F (2010) Significant coronary artery disease associated with coronary artery aneurysm and elevation of prostate-specific antigen during acute myocardial infarction (Letter). Int J Cardiol 141: e39-e42.
- Rittenhouse HG, Finlay JA, Mikolajczyk SD, Partin AW (1998) Human kallikrein 2 (hk2) and prostate specific antigen (PSA): two closely related, but distinct, kallikreins in the prostate. (Abstract). Crit Rev Clin Lab Sci 35: 275-368.
- Sharma JN (2006) Role of tissue kallikrein-kininogen-kinin pathways in the cardiovascular system. Arch Med Res 37: 299-306.
- Sharma JN (2005) The Kallikrein-Kinin System: from mediator of inflammation to modulator of cardioprotection. Inflammopharmacology 12: 591-596.