title: Pentraxin-3 predicts functional recovery and 1-year major adverse cardiovascular events after rehabilitation of cardiac surgery patients.
abstract: BACKGROUND
  Inflammatory and vascular markers have proved to be predictors of outcome in myocardial infarction and heart failure. We evaluated several circulating markers of cardiac stress, inflammation, and endothelial function to investigate their ability to predict short-term functional recovery and long-term clinical outcome in heart surgery patients undergoing inpatient rehabilitation.
  
  
  METHODS
  This prospective, multicenter study enrolled 223 patients after heart surgery, included in a 3-week program of standardized and supervised physical training. The association between biomarkers (pentraxin-3 [PTX3], brain natriuretic peptide, high-sensitivity cardiac troponin-T [hs-cTnT] and C-reactive protein [hsCRP], creatine kinase, myoglobin, and urinary albumin excretion [UACR]) and exercise capacity (6-minute walk test, 6MWT) or 1-year incidence of major adverse cardiovascular events (MACE) was tested in models that included biohumoral markers, and clinical and instrumental variables.
  
  
  RESULTS
  The patients (69.5% men, mean age of 67 ± 11 years) were enrolled after valvular surgery (52.7%) and 58.6% after coronary artery bypass grafting (CABG). Exercise capacity improved during rehabilitation (6MWT distance from 279 ± 95 to 386 ± 91 m; P < .0001); concentrations of most biomarkers decreased (hsCRP: 79% [P < .0001]; hs-cTnT: 57% [P < .0001]; UACR: 36% [P = .05]). Among the tested markers, PTX3 showed the closest association with 6MWT distance (P = .01) and was the only predictor of MACE, also in the subgroup of CABG patients (OR [95% CI] = 1.14 [1.03-1.27]; P = .015).
  
  
  CONCLUSIONS
  PTX3, a marker of vascular inflammation and cardiovascular damage, is a predictor of short-term functional recovery and 1-year MACE in patients undergoing rehabilitation after cardiac surgery, regardless of clinical and instrumental parameters.
authors.affiliation: Rehabilitative Cardiology, IRCCS S. Maria Nascente, Don Carlo Gnocchi Foundation, Milan Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Ferratini
authors.forename: Vittorino
authors.initials: V
authors.lastname: Ripamonti
authors.forename: Serge
authors.initials: S
authors.lastname: Masson
authors.forename: Paola
authors.initials: P
authors.lastname: Grati
authors.forename: Vittorio
authors.initials: V
authors.lastname: Racca
authors.forename: Ivan
authors.initials: I
authors.lastname: Cuccovillo
authors.forename: Elena
authors.initials: E
authors.lastname: Raimondi
authors.forename: Soccorso
authors.initials: S
authors.lastname: Capomolla
authors.forename: Claudio
authors.initials: C
authors.lastname: Macchi
authors.forename: Paolo
authors.initials: P
authors.lastname: Coruzzi
authors.forename: Tarcisio
authors.initials: T
authors.lastname: Vago
authors.forename: Maria
authors.initials: M
authors.lastname: Calvo
authors.forename: Alberto
authors.initials: A
authors.lastname: Mantovani
authors.forename: Roberto
authors.initials: R
authors.lastname: Latini
mesh_terms: D000368:Aged; D015415:Biomarkers; D002097:C-Reactive Protein / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000517:prevention & control; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004730:Endothelium, Vascular; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood; D007558:Italy; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011184:Postoperative Period; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D000683:Serum Amyloid P-Component / Q000032:analysis*; D013223:Statistics as Topic; D013312:Stress, Physiological; D013997:Time Factors; D016896:Treatment Outcome; D020107:Troponin T / Q000097:blood*; D000099153:Pentraxins
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D020097:Natriuretic Peptide, Brain; D000683:Serum Amyloid P-Component; D020107:Troponin T; D000099153:Pentraxins