title: Serum pentraxin 3 levels are associated with the complexity and severity of coronary artery disease in patients with stable angina pectoris.
abstract: BACKGROUND
  Atherosclerosis is a complex inflammatory process in which inflammatory markers are involved. Although pentraxin 3 (PTX-3), a newly identified inflammatory marker, was associated with adverse outcomes in stable angina pectoris, no association between PTX-3 and the complexity of coronary artery disease (CAD) has been reported. Thus, the aim of the present study was to assess the association between the level of PTX-3 and the complexity and severity of CAD assessed with SYNTAX and Gensini scores in patients with stable angina pectoris.
  
  
  METHODS
  The study population consisted of 2 groups: 161 patients with anginal symptoms and evidence of ischemia who underwent coronary angiography and 50 age- and sex- matched control subjects without evidence of ischemia were included. Patients were grouped into 3 groups according to the complexity and severity of coronary lesions assessed by the SYNTAX score (30 patients with a SYNTAX score of 0 were excluded). Serum PTX-3 and high-sensitivity C-reactive protein (hs-CRP) levels were measured.
  
  
  RESULTS
  The PTX-3 levels demonstrated an increase from low to high SYNTAX groups (r = 0.72, P < 0.001). Whereas the low SYNTAX group had statistically significantly higher PTX-3 levels when compared with the control group (0.50 ± 0.01 vs 0.24 ± 0.01 ng/mL, P < 0.001), the hs-CRP levels were not different (0.81 ± 0.42 vs 0.86 ± 0.53 mg/dL, P = 0.96). However, the intermediate SYNTAX group had higher hs-CRP levels compared with the low SYNTAX group (1.3 ± 0.66 vs 0.86 ± 0.53 mg/dL, P = 0.002). Serum PTX-3 levels and hs-CRP levels were correlated with the SYNTAX scores and Gensini scores (for SYNTAX: r = 0.87 [P < 0.001] and r = 0.36 [P = 0.01]; for Gensini: r = 0.75 [P < 0.001] and r = 0.27 [P = 0.002], respectively), and according to the results of univariate and multivariate analyses, for "intermediate and high" SYNTAX scores, age, diabetes mellitus, low-density lipoprotein cholesterol, hs-CRP, and PTX-3 were found to be independent predictors, whereas for the presence of "high" SYNTAX score only PTX-3 was found to be an independent predictor. The receiver operating characteristic curve analysis further revealed that the PTX-3 level was a strong indicator of high SYNTAX score with an area under the curve of 0.91 (95% confidence interval, 0.86-0.96).
  
  
  CONCLUSIONS
  Pentraxin 3, a novel inflammatory marker, was more tightly associated with the complexity and severity of CAD than hs-CRP and was found to be an independent predictor for high SYNTAX score.
authors.affiliation: Departments of Cardiology, Mustafa Kemal University, Tayfur Ata Sokmen Medical School, Turkey. mfkarakas@hotmail.com
authors.forename: Mehmet Fatih
authors.initials: MF
authors.lastname: Karakas
authors.forename: Eyup
authors.initials: E
authors.lastname: Buyukkaya
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kurt
authors.forename: Sedat
authors.initials: S
authors.lastname: Motor
authors.forename: Adnan Burak
authors.initials: AB
authors.lastname: Akcay
authors.forename: Sule
authors.initials: S
authors.lastname: Buyukkaya
authors.forename: Esra
authors.initials: E
authors.lastname: Karakas
authors.forename: Perihan
authors.initials: P
authors.lastname: Bilen
authors.forename: Nihat
authors.initials: N
authors.lastname: Sen
mesh_terms: D000209:Acute-Phase Proteins / Q000378:metabolism*; D060050:Angina, Stable / Q000097:blood* / Q000150:complications / Q000473:pathology; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000683:Serum Amyloid P-Component / Q000378:metabolism*; D012720:Severity of Illness Index; D000099153:Pentraxins
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D002097:C-Reactive Protein; D000683:Serum Amyloid P-Component; D000099153:Pentraxins