Significant coronary artery disease associated with coronary artery aneurysm and elevation of prostate-specific antigen during acute myocardial infarction

Prostate-specific antigen kallikrein and acute myocardial infarction: Where we are. Where are we going?

“…Unlike PSA, hK2 has also been found to activate the single-chain urokinase type plasminogen activator (uPA) [30] and it has also been found to form a complex with plasminogen activator inhibitor-1 (PAI-1), the primary inhibitor of uPA in tissues [31]. Our preliminary observations have concluded that when elevation of PSA occurs during AMI coronary lesions are frequent and often more severe than when a diminution of PSA occurs during AMI [20,23]. Moreover, our preliminary observations have also concluded that when an elevation of PSA occurs during AMI, it seems to relate to a higher occurrence of major adverse cardiac events in the first 8 days after AMI than when a diminution of PSA is seen.…”

“…We have also reported elevation of PSA during AMI after transurethral resection of the prostate (TURP) and without histological diagnosis of prostate cancer in a patient with a significant severe three vessels coronary artery disease [19]. We have also reported a significant coronary artery disease associated with coronary artery aneurysm and elevation of PSA during AMI [20]. This pattern of PSA during AMI however, has recently been questioned.…”

“…PSA was also detected in other nonprostatic sources including human breast milk [14] and in 30% of breast tumors [15] and it was considered a sensitive molecular marker of hormone responsiveness [13]. Increased PSA serum levels, are a common finding in patients with nonprostatic illnesses [14,15] including AMI [16][17][18][19][20][21]. Prolonged cardiopulmonary resuscitation(CPR) is frequently associated with increases of PSA [10,22] interpreted as marker for ischemic prostatic cell damage during CPR [10].…”

Prostate-specific antigen kallikrein complexes and acute myocardial infarction

“…Increased PSA serum levels have been reported during prolonged cardiopulmonary resuscitation [2,3], cardiac surgery [4], extracorporeal cardiopulmonary bypass [5,6], cardiogenic shock due to acute myocardial infarction (AMI) [7] and AMI [8][9][10][11][12][13]. However, the finding of diminished PSA during AMI and the correlation of variation of PSA with coronary lesions and occurrence of major adverse cardiac events have opened a possible new intriguing scenario [14,15].…”

ST-segment elevation and diminution of prostate-specific antigen in a patient with coronary spasm and without significant coronary stenoses

“…Apparently spurious result has been reported in a work about mean serum PSA concentration during acute myocardial infarction(AMI) with mean serum PSA concentration significantly lower on day 2 than either day 1 or day 3 and it has been reported that these preliminary results could reflect several factors, such as antiinfarctual treatment, reduced physical activity or an acute-phase response [4]. Both elevated [5][6][7][8][9] as well as diminished PSA [10] have been reported during acute myocardial infarction and our preliminary observations [10,11] have concluded that when elevation of PSA occurs during AMI, coronary lesions are frequent and often more severe than when a diminution of PSA occurs. Moreover, our preliminary observations have concluded also that when elevation of prostate-specific antigen occurs during AMI, it seems to relate to a higher occurrence of major adverse cardiac events in the first 8 days after AMI than when a diminution of PSA occurs [11].…”