Association of Plasma Pentraxin-3 Levels on Admission with In-hospital Mortality in Patients with Acute Type A Aortic Dissection

Zhou, Qin; Chai, Xiangping; Fang, Zhenfei; Hu, Xinqun; Tang, Liang

doi:10.4103/0366-6999.192785

Cited by 14 publications

(18 citation statements)

References 28 publications

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“…The difference between median CRP levels did not reach statistical significance in deceased patients compared to those who survived the first month of the TMA episode. This observation conforms published reports in regard to the association of PTX3 to acute disease mortality in multiple conditions including severe sepsis (37, 38), ventilation assisted pneumonia (39) and acute aortic type A dissection (40). Besides, PTX3 was reported to be a long-term prognostic marker of mortality in patients undergoing hemodialysis (41) and of cardiovascular death in patients with renal disease (42), whereas some studies even place PTX3 superior to CRP as a predictor of mortality (39), endothelial dysfunction (43) or indicator of local inflammatory response following vascular injury (44).…”

Section: Discussionsupporting

confidence: 92%

Elevated Systemic Pentraxin-3 Is Associated With Complement Consumption in the Acute Phase of Thrombotic Microangiopathies

et al. 2019

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Pentraxin-3 (PTX3) and C-reactive protein (CRP) have been shown to regulate complement activation in vitro , but their role has not been investigated in complement consumption in vivo . Thrombotic microangiopathies (TMA) are often accompanied by complement overactivation and consumption, therefore we analyzed the relation of the systemic pentraxin levels to the complement profile, laboratory parameters and clinical outcome of TMA patients. We determined the PTX3 and CRP levels, complement factor and activation product concentrations in blood samples of 171 subjects with the diagnosis of typical hemolytic uremic syndrome (STEC-HUS) ( N = 34), atypical HUS (aHUS) ( N = 44), secondary TMA ( N = 63), thrombotic thrombocytopenic purpura (TTP) ( N = 30) and 69 age-matched healthy individuals. Clinical data, blood count and chemistry were collected from medical records. To determine the in vitro effect of PTX3 on alternative pathway (AP) activation, sheep red blood cell-based hemolytic assay and AP activity ELISA were used. We found that PTX3 levels were elevated in the acute phase of STEC-HUS, aHUS and secondary TMA, whereas PTX3 elevation was exceptional is TTP. Conversely, a significantly higher median CRP was present in all patient groups compared to controls. PTX3, but not CRP was associated with signs of complement consumption in vivo , and PTX3 significantly decreased the AP hemolytic activity in vitro . Our results provide a detailed description of acute phase-TMA patients' complement profile linked to changes in the systemic pentraxin levels that may support further molecular studies on the function of PTX3 in disease pathogenesis and add to the laboratory assessment of complement consumption in TMA.

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Section: Discussionsupporting

confidence: 92%

Elevated Systemic Pentraxin-3 Is Associated With Complement Consumption in the Acute Phase of Thrombotic Microangiopathies

et al. 2019

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“…Its role has been studied in connection with acute aortic dissection or acute coronary syndrome. Very little is currently known about the association between the AAA and serum levels of PTX-3 [18,19]. We proved statistically significantly higher serum levels of PTX-3 in patients with an AAA (p < 0.0001) with a high AUC value (AUC = 0.8029).…”

Section: Inflammatory Biomarkersmentioning

confidence: 55%

Blood biomarker panel recommended for personalized prediction, prognosis, and prevention of complications associated with abdominal aortic aneurysm

Moláček¹,

Třeška²,

Zeithaml³

et al. 2019

EPMA Journal

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The aim of the study was to evaluate the ability of following biomarkers as diagnostic tools and risk predictors of AAA: Creactive protein, interleukin-6, pentraxin-3, galectin-3, procollagen type III N-terminal peptide, C-terminal telopeptide of type I collagen, high-sensitive troponin I, and brain natriuretic peptide. Seventy-two patients with an AAA and 100 healthy individuals were enrolled into the study. We assessed individual biomarker performance and correlation between the AAA diameter and biomarker levels, and also, a multivariate logistic regression was used to design a possible predictive model of AAA growth and rupture risk. We identified following four parameters with the highest potential to find a useful place in AAA diagnostics: galectin-3, pentraxin-3, interleukin-6, and C-terminal telopeptide of type I. The best biomarkers in our evaluation (galectin-3 and pentraxin-3) were AAA diameter-independent. With the high AUC and AAA diameter correlation, the high-sensitive troponin I can be used as an independent prognostic biomarker of the upcoming heart complications in AAA patients. Authors recommend to add biomarkers as additional parameters to the current AAA patient management. Main addition value of biomarkers is in the assessment of the AAA with the smaller diameter. Elevated biomarkers can change the treatment decision, which would be done only based on AAA diameter size. The best way how to manage the AAA patients is to create a reliable predictive model of AAA growth and rupture risk. A created multiparameter model gives very promising results with the significantly higher efficiency compared with the use of the individual biomarkers.

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“…[ 1 ] AAD requires rapid diagnosis and appropriate treatment to improve survival and prevent potentially fatal complications. [ 2 3 ] Over the past two decades, understanding on the natural history, diagnosis, and management of AAD has improved considerably. Although several studies have focused on AAD, few data exist on sex-related differences in clinical presentation, diagnostic imaging, management, and outcomes in a large cohort.…”

Section: Introductionmentioning

confidence: 99%

Correlation between Sex and Prognosis of Acute Aortic Dissection in the Chinese Population

Liu

Wang

et al. 2018

Chinese Medical Journal

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Background:The prevalence, presentation, management, and prognosis of coronary heart disease differ according to sex. Greater understanding on the differences between men and women with acute aortic dissection (AAD) is needed. We aimed to investigate whether sex disparities are found in patients with AAD, and to study sex differences in complications, mortality in-hospital, and long-term.Methods:We included 884 patients enrolled in our institute between June 2002 and May 2016. Considering psychosocial factors, treatments, and the outcomes in men versus those in women with AAD, we explored the association of sex with psychosocial characteristics and mortality risk. For categorical variables, significant differences between groups were assessed with the Chi-square test or Fisher's exact test, and continuous parameters were assessed with Student's t-test. Univariate and stratified survival statistics were computed using Kaplan-Meier analysis.Results:A total of 884 patients (76.1% male, mean age 51.4 ± 11.8 years) were included in this study. There were fewer current smokers in female compared with male (17.5% vs. 67.2%, χ2 = 160.06, P < 0.05). The percentage of men who reported regular alcohol consumption was significantly higher than that in women (40.6% vs. 3.8%, χ2 = 100.18, P < 0.05). About 6.2% (55 of 884) of patients with AAD died before vascular or endovascular surgery was performed, 34.4% (304 of 884) of patients underwent surgical procedures, and 52.7% (466 of 884) and 12.8% (113 of 884) of patients received endovascular treatment and medication. Postoperative mortality similar (6.0% vs. 5.6%, respectively, χ2 = 0.03, P = 0.91) between men and women. Follow-up was completed in 653 of 829 patients (78.8%). Adjustment for age, history of coronary disease, hypertension, smoking and drinking, Type A and use of beta-blocker, angiotensin II receptor blockers, angiotensin converting enzyme (ACE) inhibitor, calcium-channel blockers and statins by multivariate logistic regression analysis suggested that age (odds ratios [ORs], 1.04; 95% confidence interval [CI], 1.01–1.07; P < 0.05), using of calcium-channel blockers (OR, 0.37; 95% CI, 0.18–0.74; P < 0.05), at discharge were independent predictors of late mortality, ACE inhibitors (OR, 1.91; 95% CI, 1.03–3.54; P = 0.04) was independent risk factor of late mortality.Conclusions:In Chinese with AAD, sex is not independently associated with long-term clinical outcomes. Age, the intake of calcium-channel blockers at discharge might help to improve long-term outcomes.

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Association of Plasma Pentraxin-3 Levels on Admission with In-hospital Mortality in Patients with Acute Type A Aortic Dissection

Cited by 14 publications

References 28 publications

Elevated Systemic Pentraxin-3 Is Associated With Complement Consumption in the Acute Phase of Thrombotic Microangiopathies

Elevated Systemic Pentraxin-3 Is Associated With Complement Consumption in the Acute Phase of Thrombotic Microangiopathies

Blood biomarker panel recommended for personalized prediction, prognosis, and prevention of complications associated with abdominal aortic aneurysm

Correlation between Sex and Prognosis of Acute Aortic Dissection in the Chinese Population

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