Pentraxin-3 in chronic heart failure: The CORONA and GISSI-HF trials

Roberto Latini, Lars Gullestad, Serge Masson, Ståle Haugset Nymo, Thor Ueland, Ivan Cuccovillo, Mari Vårdal, Barbara Bottazzi, Alberto Mantovani, Donata Lucci, Nobuhito Masuda, Yukio Sudo, John Wikstrand, Gianni Tognoni, Pål Aukrust, Luigi Tavazzi

Research output: Contribution to journalArticle

Abstract

Aims Pentraxin-3 (PTX3) is a component of the humoral arm of innate immunity which can regulate inflammatory processes. Since the role of inflammation in the progression of chronic heart failure (HF) is debated, we investigated the prognostic value of PTX3 and the effect of a statin in two large populations of patients with HF. Methods and resultsPlasma levels of PTX3 were measured at randomization and after 3 months in 1457 patients enrolled in the Controlled Rosuvastatin Multinational Trial in HF (CORONA) and 1233 patients enrolled in the GISSI-Heart Failure trial (GISSI-HF). The relationships between baseline PTX3 levels or their changes over time and mortality were evaluated with multivariable Cox proportional hazard models including clinical factors, high sensitivity C-reactive protein (hsCRP), and N-terminal pro brain natriuretic peptide (NT-proBNP). PTX3 concentration [median (Q1Q3) 5.34 (3.557.64) ng/mL, n 2690] was higher in females, in older patients, and those with lower body mass index. Baseline elevated PTX3 was associated with a higher risk of all-cause mortality [759 events, hazard ratio (HR) for 1 SD increase 1.20, 95 confidence interval (CI) 1.121.30, P <0.0001], cardiovascular mortality (587 events, HR 1.27, 95 CI 1.171.38, P <0.0001), or hospitalization for worsening HF (720 events, HR 1.21, 95 CI 1.121.30, P <0.0001), and marginally improved discrimination. Three-month changes in PTX3 were associated with fatal events after adjustment for hsCRP or NT-proBNP. Rosuvastatin lowered hsCRP levels but significantly raised PTX3.ConclusionIn two independent clinical trials that enrolled patients with chronic HF, PTX3 was consistently associated with outcomes. The opposite effects of a statin on hsCRP and PTX3 call for further investigation.Trial registrationNCT00336336 (GISSI-HF), NCT00206310 (CORONA).

Original languageEnglish
Pages (from-to)992-999
Number of pages8
JournalEuropean Journal of Heart Failure
Volume14
Issue number9
DOIs
Publication statusPublished - Sep 2012

Keywords

  • Heart failure
  • Immune system
  • Prognosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Latini, R., Gullestad, L., Masson, S., Nymo, S. H., Ueland, T., Cuccovillo, I., Vårdal, M., Bottazzi, B., Mantovani, A., Lucci, D., Masuda, N., Sudo, Y., Wikstrand, J., Tognoni, G., Aukrust, P., & Tavazzi, L. (2012). Pentraxin-3 in chronic heart failure: The CORONA and GISSI-HF trials. European Journal of Heart Failure, 14(9), 992-999. https://doi.org/10.1093/eurjhf/hfs092