Korean Circ J.  2010 Aug;40(8):370-376. 10.4070/kcj.2010.40.8.370.

Pentraxin 3 as a Novel Marker Predicting Congestive Heart Failure in Subjects With Acute Coronary Syndrome

• Lee DH
• Jeon HK
• You JH
• Park MY
• Lee SJ
• Kim SS
• Shim BJ
• Choi YS
• Shin WS
• Lee JM
• Park CS
• Youn HJ
• Chung WS
• Kim JH

• KMID: 2145528
• DOI: http://doi.org/10.4070/kcj.2010.40.8.370

Abstract

BACKGROUND AND OBJECTIVES
Pentraxin 3 (PTX3) was shown to be elevated in the acute phase of acute myocardial infarction (AMI) and to have prognostic significance in AMI patients. The aim of this study was to estimate whether the value of PTX3 could be used as a prognostic biomarker, with the global registry of acute coronary events (GRACE) risk assessment tool, in patients with acute coronary syndrome (ACS).
SUBJECTS AND METHODS
Between July 2007 and June 2008, 137 patient subjects (mean age : 61+/-12 years, M : F=108 : 29) with ACS who underwent coronary intervention, but did not have a prior percutaneous coronary intervention (PCI) and/or follow-up coronary angiogram, were enrolled. We estimated the all-cause mortality or death/MI, in-hospital and to 6 months, using the GRACE risk scores and compared these estimates with serum PTX3 concentrations.
RESULTS
The serum PTX3 concentration showed a significant increase in ST segment elevation myocardial infarction (STEMI) greater than the unstable angina pectoris (UAP) group (2.4+/-2.1 ng/mL vs. 1.3+/-0.9 ng/mL, p= 0.017, respectively), but did not show a significant difference between non-ST segment elevation myocardial infarction (NSTEMI) and the UAP group (1.9+/-1.4 ng/mL vs. 1.3+/-0.9 ng/mL, p=0.083, respectively). The serum PTX3 concentration was closely related to death/MI in-hospital (r=0.242, p=0.015) and death/MI to 6 months (r=0.224, p=0.023), respectively. The serum PTX3 concentration was not related to all-cause mortality in-hospital (r=0.112, p=0.269) and to 6 months (r=0.132, p=0.191), respectively. Among the parameters determining the GRACE risk scores, the degree of Killip class in congestive heart failure (CHF) was independently associated with the supramedian PTX3 concentration [odds ratio: 2.229 (95% confidence interval: 1.038-4.787), p=0.040].
CONCLUSION
The serum PTX3 level provides important information for the risk stratification of CHF among the parameters determining the GRACE risk scores in subjects with ACS.

Keyword

Pentraxin 3; Myocardial infarction; Acute coronary syndrome; Heart failure

MeSH Terms

Acute Coronary Syndrome
Angina, Unstable
C-Reactive Protein
Estrogens, Conjugated (USP)
Follow-Up Studies
Heart Failure
Humans
Myocardial Infarction
Percutaneous Coronary Intervention
Risk Assessment
Serum Amyloid P-Component
C-Reactive Protein
Estrogens, Conjugated (USP)
Serum Amyloid P-Component

Figure

• 

  Fig. 1 The relationship between PTX3 and several biomarkers. PTX3: pentraxin 3, CRP: C-reactive protein, CK-MB: creatine kinase myoglobulin, IMA: ischemia modified albumin, BNP: brain natriuretic peptide, pro-BNP: pro-brain natriuretic peptide.

• 

  Fig. 2 The relationship between PTX3 and ACS, including STEMI, NSTEMI and UAP groups. PTX3: pentraxin 3, ACS: acute coronary syndrome, STEMI: ST segment elevation myocardial infarction, NSTEMI: non-ST segment elevation myocardial infarction, UAP: unstable angina pectoris.

• 

  Fig. 3 ROC curve. The cut-off value of serum PTX3 concentration 0.88 ng/mL shows a sensitivity 87.5% and a specificity 69.1% for predicting the probability of all-cause mortality in-hospital (>3%), as the highest tertile of GRACE risk assessment in (A), and the cut-off value of serum PTX3 concentration 0.92 ng/mL shows a sensitivity 78.2% and a specificity 50.0% for predicting the probability of death/MI in-hospital (>5%) in (B). ROC: receiver operating characteristics, AUC: area under curve, CI: confidence interval, PTX3: pentraxin 3, GRACE: global registry of acute coronary events, MI: myocardial infarction.

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