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Pentraxin-3 predicts functional recovery and 1-year major adverse cardiovascular events after rehabilitation of cardiac surgery patients.
MedLine Citation:
PMID:  22193930     Owner:  NLM     Status:  Publisher    
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.
Maurizio Ferratini; Vittorino Ripamonti; Serge Masson; Paola Grati; Vittorio Racca; Ivan Cuccovillo; Elena Raimondi; Soccorso Capomolla; Claudio Macchi; Paolo Coruzzi; Tarcisio Vago; Maria Calvo; Alberto Mantovani; Roberto Latini
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-21
Journal Detail:
Title:  Journal of cardiopulmonary rehabilitation and prevention     Volume:  -     ISSN:  1932-751X     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101291247     Medline TA:  J Cardiopulm Rehabil Prev     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Rehabilitative Cardiology, IRCCS S. Maria Nascente, Don Carlo Gnocchi Foundation (Drs Ferratini, Ripamonti, Grati, Racca, and Calvo), Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche Mario Negri (Drs Masson and Latini and Ms Raimondi), Laboratory of Endocrinology, Ospedale Luigi Sacco (Dr Vago), Department of Translational Medicine, University of Milan, Milan Italy (Dr Mantovani); Research Laboratory in Immunology and Inflammation, Istituto Clinico Humanitas, Rozzano, Italy (Drs Cuccovillo and Mantovani); Ospedale Criscuoli S. Angelo dei Lombardi, Don Carlo Gnocchi Foundation, Avellino, Italy (Dr Capomolla); Rehabilitative Cardiology, IRCCS S. Maria agli Ulivi, Pozzolatico, Don Carlo Gnocchi Foundation, Florence, Italy (Dr Macchi); and Rehabilitative Cardiology, S. Maria ai Servi, Don Carlo Gnocchi Foundation, Parma, Italy (Dr Coruzzi).
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