Prognostic Significance of the Long Pentraxin PTX3 in Acute Myocardial Infarction

Abstract

Background-Inflammation has a pathogenetic role in acute myocardial infarction (MI). Pentraxin-3 (PTX3), a long pentraxin produced in response to inflammatory stimuli and highly expressed in the heart, was shown to peak in plasma Ϸ7 hours after MI. The aim of this study was to assess the prognostic value of PTX3 in MI compared with the best-known and clinically relevant biological markers. Methods and Results-In 724 patients with MI and ST elevation, PTX3, C-reactive protein (CRP), creatine kinase (CK), troponin T (TnT), and N-terminal pro-brain natriuretic peptide (NT-proBNP) were assayed at entry, a median of 3 hours, and the following morning, a median of 22 hours from symptom onset. With respect to outcome events occurring over 3 months after the index event, median PTX3 values were 7.08 ng/mL in event-free patients, 16.12 ng/mL in patients who died, 9.12 ng/mL in patients with nonfatal heart failure, and 6.88 ng/mL in patients with nonfatal residual ischemia (overall PϽ0.0001). Multivariate analysis including CRP, CK, TnT, and NT-proBNP showed that only age Ն70 years (OR, 2.11; 95% CI, 1.04 to 4.31), Killip class Ͼ1 at entry (OR, 2.20; 95% CI, 1.14 to 4.25), and PTX3 (Ͼ10.73 ng/mL) (OR, 3.55; 95% CI, 1.43 to 8.83) independently predicted 3-month mortality. Biomarkers predicting the combined end point of death and heart failure in survivors were the highest tertile of PTX3 and of NT-proBNP and a CK ratio Ͼ6. Conclusions-In a representative contemporary sample of patients with MI with ST elevation, the acute-phase protein PTX3 but not the liver-derived short pentraxin CRP or other cardiac biomarkers (NT-proBNP, TnT, CK) predicted 3-month mortality after adjustment for major risk factors and other acute-phase prognostic markers.

Supplementation with omega-3 acids after myocardial infarction and modification of inflammatory markers in light of the patients’ diet: a preliminary study

“…In addition, the same study demonstrated that acute cardiac events were more common in patients with high PTX3 plasma concentration than in patients with normal PTX3 level [22]. PTX3 is also considered a good early marker of acute MI [23]. In our study, low baseline levels of PTX3 were observed both in the omega-3 group and the placebo group.…”

Pentraxin-3 Predicts Functional Recovery and 1-Year Major Adverse Cardiovascular Events After Rehabilitation of Cardiac Surgery Patients

“…20 In addition, neutrophils contain a store of mature protein in their specific granules and can promptly release the molecule in response to proinflammatory signals. 21 Pentraxin is also expressed in cardiac tissue after MI, [17][18][19][20][21][22] and its plasma concentration predicts cardiovascular morbidity and mortality in patients with unstable angina, 23 MI, 24 or heart failure. 25 As expected, we found that patients admitted to a rehabilitation program after cardiac surgery presented with high concentrations of the biomarkers related to cardiac stress or injury (brain natriuretic peptide, cardiac troponin-T, creatine kinase, and myoglobin), generalized inflammation and vascular injury (C-reactive protein and pentraxin-3), and early renal glomerular dysfunction (albumin urinary excretion), but the marked decrease in biomarker levels during rehabilitation supports the global effectiveness of even short-term programs.…”

Elevated Plasma and Alveolar Levels of Soluble Receptor for Advanced Glycation Endproducts Are Associated with Severity of Lung Dysfunction in ARDS Patients

“…Soluble RAGE (sRAGE), an extracellular domain of RAGE, was measured in duplicate in plasma and BALf samples (detection limit 4 pg/ml) using a specific enzymelinked immunosorbent assay (ELISA) (R&D Systems, Minneapolis, MN, USA) according to the manufacturer's protocols. PTX3 was assayed in duplicate by sandwich ELISA (detection limit 0.1 ng/ml), as previously described (Latini et al 2004). ELISA for PTX3 does not cross-react with CRP.…”