OBJECTIVE: This study aimed to investigate whether pregnancy associated with plasma protein-A (PAPP-A) is useful for risk assessment in elderly patients with coronary syndrome (ACS).METHODS: PAPP-A was measured in 455 elderly patients with ACS.These patients were followed for 12 months.A cut point was made according to the ROC curve, and the patients were divided into high level group and low level group, in order to evaluate the association between the PAPP-A and the incidence of the combined cardiovascular events.