Pentraxin 3 in unstable angina and non-ST-segment elevation myocardial infarction.
OBJECTIVE
We prospectively investigated the prognostic value of pentraxin 3 (PTX3) in patients with unstable angina and non-ST-segment elevation myocardial infarction (UA/NSTEMI).


BACKGROUND
PTX3 may be a useful marker for localized vascular inflammation and damage to the cardiovascular system. Recent studies have shown that plasma PTX3 is elevated in patients with UA/NSTEMI; however, its prognostic value in UA/NSTEMI remains unclear.


METHODS
PTX3, high-sensitivity C-reactive protein (hsCRP), N-terminal pro-B-type natriuretic peptide (NT-proBNP), and cardiac troponin I were measured on admission in 204 consecutive patients (mean age of 69 years; 144 males) hospitalized for UA/NSTEMI within 24h (mean of 7.5h) after the onset of chest symptoms. A cardiac event, which was defined as cardiac death, rehospitalization for acute coronary syndrome (ACS), or rehospitalization for worsening heart failure, was monitored for 6 months after admission.


RESULTS
A total of 26 (13%) cardiac events occurred during the 6-month follow-up period. In a stepwise Cox regression analysis including 18 well-known clinical and biochemical predictors of ACS outcome, both PTX3 (relative risk 3.86 per 10-fold increment, P=0.01) and NT-proBNP (relative risk 2.16 per 10-fold increment, P=0.02), but not hsCRP, were independently associated with the 6-month cardiac event. The cardiac event rate was higher in patients with increased PTX3 (> or = 3.1ng/mL of median value) than those without (20% vs. 5.8%, P=0.003). A Kaplan-Meier analysis revealed that patients with increased PTX3 had a higher risk for cardiac events than those without (P=0.002).


CONCLUSIONS
PTX3 and NT-proBNP may be potent and independent predictors for 6-month cardiac events in patients hospitalized for UA/NSTEMI within 24h after the onset. Measurement of plasma PTX3 may substantially improve the early risk stratification of patients with UA/NSTEMI.
Matsui
Shigeru
S
Division of Critical Care, Fujita Health University Graduate School of Health Sciences, Fujita Health University, Toyoake, Japan.
Ishii
Junnichi
J
Kitagawa
Fumihiko
F
Kuno
Atsuhiro
A
Hattori
Kousuke
K
Ishikawa
Makoto
M
Okumura
Masanori
M
Kan
Shino
S
Nakano
Tadashi
T
Naruse
Hiroyuki
H
Tanaka
Ikuko
I
Nomura
Masanori
M
Hishida
Hitoshi
H
Ozaki
Yukio
Y
D000368:Aged; D000789:Angina, Unstable / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D005260:Female; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic; D009203:Myocardial Infarction / Q000097:blood* / Q000503:physiopathology; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011379:Prognosis; D000683:Serum Amyloid P-Component / Q000032:analysis*; D014336:Troponin / Q000097:blood; D000099153:Pentraxins
D015415:Biomarkers; D002097:C-Reactive Protein; D020097:Natriuretic Peptide, Brain; D010446:Peptide Fragments; D000683:Serum Amyloid P-Component; D014336:Troponin; D000099153:Pentraxins; C109794:pro-brain natriuretic peptide (1-76)