Prostate-specific antigen levels in hypertensive patients suffering from a non-ST elevation myocardial infarction or a new-onset atrial fibrillation

Prostate-specific antigen kallikrein and non-ST elevation myocardial infarction

“…However, also decreased PSA serum levels have been reported during AMI [2,21,22] and this latter finding has opened a new possible intriguing scenario [1,16,18,21,23]. Recently, an association between PSA levels and aortic stiffness has been also reported in untreated essential hypertensive males [24], and lately a higher percentage of age-specific PSA ranges relates to the occurrence of non-ST elevation myocardial infarction (NSTEMI) in a study of evaluation between NSTEMI and new-onset atrial fibrillation regarding hypertensive male patients [23]. Although these evidences have been gathered, there remain, however, several critical questions that can defy our ability to understand the variation of PSA during cardiovascular events and particularly during NSTEMI.…”

“…Of note, increased PSA serum levels have been reported after prolonged cardiopulmonary resuscitation [4,5], cardiac surgery [6], extracorporeal cardiopulmonary bypass [7,8], cardiogenic shock due to acute myocardial infarction (AMI) [9], AMI [10][11][12][13][14][15][16][17][18][19] and coronary artery stenting [20]. However, also decreased PSA serum levels have been reported during AMI [2,21,22] and this latter finding has opened a new possible intriguing scenario [1,16,18,21,23]. Recently, an association between PSA levels and aortic stiffness has been also reported in untreated essential hypertensive males [24], and lately a higher percentage of age-specific PSA ranges relates to the occurrence of non-ST elevation myocardial infarction (NSTEMI) in a study of evaluation between NSTEMI and new-onset atrial fibrillation regarding hypertensive male patients [23].…”

“…Increasing evidence has reinforced the concept of PSA as a ubiquitous protein with more multifarious biological activity than previously believed [18,25] and it is important to avoid possible confounding effects : e.g. prostatic illnesses, malignancy, inflammatory disease (including clinical prostatitis), surgery or trauma cardiopulmonary resuscitation, cardiogenic shock on admission, and urinary catheterization [23]. Moreover, the metabolism of PSA [26] as well as the exact mechanism of its variation related to cardiovascular conditions are not, yet, clearly fully understood [22].…”

“…Furthermore, both an androgen-independent expression of PSA [28,29] and an androgendependent expression of PSA have been reported [30][31][32]. PSA also gradually change with age and it is preferable to use the percentage of agespecific PSA ranges (a.s. PSA) instead of the simple PSA levels [23,33]. Another question concerns the variation of PSA as it relates to its raise and/ or its diminution during acute coronary syndrome and as it relates to the severity of the underlying coronary artery disease [2,3,17,[21][22][23], and to occurrence of major adverse cardiac events after AMI [2,3,17,21].…”

“…PSA also gradually change with age and it is preferable to use the percentage of agespecific PSA ranges (a.s. PSA) instead of the simple PSA levels [23,33]. Another question concerns the variation of PSA as it relates to its raise and/ or its diminution during acute coronary syndrome and as it relates to the severity of the underlying coronary artery disease [2,3,17,[21][22][23], and to occurrence of major adverse cardiac events after AMI [2,3,17,21]. An acutephase response [12] and a prostatic ischemia and/or infarction [22] have been implicated in PSA elevation.…”