Prognostic significance of the long pentraxin PTX3 in acute myocardial infarction

Roberto Latini, Aldo P. Maggioni, Giuseppe Peri, Lucio Gonzini, Donata Lucci, Paolo Mocarelli, Luca Vago, Fabio Pasqualini, Stefano Signorini, Dario Soldateschi, Lorenzo Tarli, Carlo Schweiger, Claudio Fresco, Rossana Cecere, Gianni Tognoni, Alberto Mantovani

Research output: Contribution to journalArticlepeer-review

Abstract

Background - Inflammation has a pathogenetic role in acute myocardial infarction (MI). Pentraxin-3 (PTX3), a long pentraxin produced in response to inflammatory stimuli and highly expressed in the heart, was shown to peak in plasma ≈7 hours after MI. The aim of this study was to assess the prognostic value of PTX3 in MI compared with the best-known and clinically relevant biological markers. Methods and Results - In 724 patients with MI and ST elevation, PTX3, C-reactive protein (CRP), creatine kinase (CK), troponin T (TnT), and N-terminal pro-brain natriuretic peptide (NT-proBNP) were assayed at entry, a median of 3 hours, and the following morning, a median of 22 hours from symptom onset. With respect to outcome events occurring over 3 months after the index event, median PTX3 values were 7.08 ng/mL in event-free patients, 16.12 ng/mL in patients who died, 9.12 ng/mL in patients with nonfatal heart failure, and 6.88 ng/mL in patients with nonfatal residual ischemia (overall P1 at entry (OR, 2.20; 95% CI, 1.14 to 4.25), and PTX3 (>10.73 ng/mL) (OR, 3.55; 95% CI, 1.43 to 8.83) independently predicted 3-month mortality. Biomarkers predicting the combined end point of death and heart failure in survivors were the highest tertile of PTX3 and of NT-proBNP and a CK ratio >6. Conclusions - In a representative contemporary sample of patients with MI with ST elevation, the acute-phase protein PTX3 but not the liver-derived short pentraxin CRP or other cardiac biomarkers (NT-proBNP, TnT, CK) predicted 3-month mortality after adjustment for major risk factors and other acute-phase prognostic markers.

Original languageEnglish
Pages (from-to)2349-2354
Number of pages6
JournalCirculation
Volume110
Issue number16
DOIs
Publication statusPublished - Oct 19 2004

Keywords

  • C-reactive protein
  • Myocardial infarction
  • Natriuretic peptide, brain
  • Troponin

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

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