Prognostic Significance of the Long Pentraxin PTX3 in Acute Myocardial Infarction
| Autor: | Rossana Cecere, Fabio Pasqualini, Stefano Signorini, Giuseppe Peri, Roberto Latini, Alberto Mantovani, Donata Lucci, Carlo Schweiger, Lorenzo Tarli, Paolo Mocarelli, Gianni Tognoni, Claudio Fresco, Lucio Gonzini, Aldo P. Maggioni, Luca Vago, Dario Soldateschi |
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| Rok vydání: | 2004 |
| Předmět: |
Male
medicine.medical_specialty Myocardial Infarction Myocardial Ischemia Nerve Tissue Proteins Electrocardiography Troponin T Physiology (medical) Internal medicine Natriuretic Peptide Brain medicine Humans Protein Isoforms Prospective Studies Myocardial infarction Creatine Kinase Aged Killip class Aged 80 and over Heart Failure biology business.industry ST elevation C-reactive protein Middle Aged Prognosis medicine.disease Troponin Peptide Fragments Serum Amyloid P-Component C-Reactive Protein Treatment Outcome Endocrinology Italy Heart failure biology.protein Cardiology Female Creatine kinase Cardiology and Cardiovascular Medicine business Biomarkers Follow-Up Studies |
| Zdroj: | Circulation. 110:2349-2354 |
| ISSN: | 1524-4539 0009-7322 |
| DOI: | 10.1161/01.cir.0000145167.30987.2e |
| Popis: | 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 P 1 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. |
| Databáze: | OpenAIRE |
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