title: Clinical and prognostic implications of circulating pentraxin 3 levels in non ST-elevation acute coronary syndrome.
abstract: OBJECTIVE
  Pentraxin 3 (PTX3) is the prototype of the long pentraxin family. PTX3 is involved in inflammatory processes affecting the cardiovascular system, and PTX3 levels have been shown to be elevated and independently prognostic in ST-elevation myocardial infarction. Data on PTX3 levels in non-ST-elevation acute coronary syndrome (NSTE-ACS), in contrast, are limited. The aim of the present analysis was to investigate the implications of PTX3 levels in a fairly large sample of NSTE-ACS patients and in comparison to levels of C-reactive protein (CRP).
  
  
  METHODS
  We measured levels of PTX3 and CRP in both 82 healthy controls and 401 NSTE-ACS patients from the GUSTO IV study, and studied the associations of these biomarkers to clinical data and 1-year mortality.
  
  
  RESULTS
  NSTE-ACS patients had significantly higher median PTX3 levels compared to healthy controls (3.8 vs. 1.9 μg/L; p<0.001). PTX3 levels in patients with NSTE-ACS were independently related to female sex and cardiac troponin T levels, but not to age or cardiovascular risk factors. PTX3 levels were higher in patients who died within 1 year but did not emerge as an independent predictor of 1-year mortality (adjusted OR 1.2 [95% CI 0.6-2.3]). This was in contrast to CRP (adjusted OR 1.5 [95% CI 1.1-2.3]). Neither PTX3 nor CRP yielded significant discriminative value regarding mortality prediction.
  
  
  CONCLUSIONS
  PTX3 levels are elevated in NSTE-ACS. However, the prognostic information provided by PTX3 levels is limited and inferior compared to CRP. Our data, thus, do not support the measurement of PTX3 in patients with NSTE-ACS.
authors.affiliation: Dept. of Medical Sciences, Cardiology, Uppsala University, 75237 Uppsala, Sweden. Electronic address: kai.eggers@ucr.uu.se.
authors.forename: Kai M
authors.initials: KM
authors.lastname: Eggers
authors.forename: Paul W
authors.initials: PW
authors.lastname: Armstrong
authors.forename: Robert M
authors.initials: RM
authors.lastname: Califf
authors.forename: Nina
authors.initials: N
authors.lastname: Johnston
authors.forename: Maarten L
authors.initials: ML
authors.lastname: Simoons
authors.forename: Per
authors.initials: P
authors.lastname: Venge
authors.forename: Stefan K
authors.initials: SK
authors.lastname: James
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000000981:diagnostic imaging* / Q000401:mortality; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D011379:Prognosis; D000683:Serum Amyloid P-Component / Q000378:metabolism*; D013548:Sweden / Q000453:epidemiology; D014463:Ultrasonography; D000099153:Pentraxins
chemical_list: D002097:C-Reactive Protein; D000683:Serum Amyloid P-Component; D000099153:Pentraxins
keywords: Acute coronary syndrome; Inflammatory biomarkers; Mortality; Outcome prediction; Pentraxin 3