TY - JOUR
T1 - Pentraxin-3 predicts functional recovery and 1-year major adverse cardiovascular events after rehabilitation of cardiac surgery patients
AU - Ferratini, Maurizio
AU - Ripamonti, Vittorino
AU - Masson, Serge
AU - Grati, Paola
AU - Racca, Vittorio
AU - Cuccovillo, Ivan
AU - Raimondi, Elena
AU - Capomolla, Soccorso
AU - Macchi, Claudio
AU - Coruzzi, Paolo
AU - Vago, Tarcisio
AU - Calvo, Maria
AU - Mantovani, Alberto
AU - Latini, Roberto
PY - 2012/1
Y1 - 2012/1
N2 - 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). CONCLUSION: 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.
AB - 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). CONCLUSION: 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.
KW - biomarkers
KW - cardiac rehabilitation
KW - cardiac surgery
KW - pentraxin-3
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U2 - 10.1097/HCR.0b013e31823be0f4
DO - 10.1097/HCR.0b013e31823be0f4
M3 - Article
C2 - 22193930
AN - SCOPUS:84855345096
VL - 32
SP - 17
EP - 24
JO - Journal of Cardiopulmonary Rehabilitation and Prevention
JF - Journal of Cardiopulmonary Rehabilitation and Prevention
SN - 1932-7501
IS - 1
ER -