Document Detail

Prognostic significance of the long pentraxin PTX3 in acute myocardial infarction.
MedLine Citation:
PMID:  15477419     Owner:  NLM     Status:  MEDLINE    
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 approximately 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<0.0001). Multivariate analysis including CRP, CK, TnT, and NT-proBNP showed that only age > or =70 years (OR, 2.11; 95% CI, 1.04 to 4.31), Killip class >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.
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;
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't; Validation Studies     Date:  2004-10-11
Journal Detail:
Title:  Circulation     Volume:  110     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-10-19     Completed Date:  2005-07-06     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2349-54     Citation Subset:  AIM; IM    
Mario Negri Institute for Pharmacological Research, Milan, Italy.
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MeSH Terms
Aged, 80 and over
Biological Markers
C-Reactive Protein / analysis*,  chemistry
Creatine Kinase / blood
Follow-Up Studies
Heart Failure / blood,  epidemiology,  etiology
Italy / epidemiology
Middle Aged
Myocardial Infarction / blood*,  complications,  mortality
Myocardial Ischemia / epidemiology
Natriuretic Peptide, Brain
Nerve Tissue Proteins / blood
Peptide Fragments / blood
Prospective Studies
Protein Isoforms / blood,  chemistry
Serum Amyloid P-Component / analysis*,  chemistry
Treatment Outcome
Troponin T / blood
Reg. No./Substance:
0/Biological Markers; 0/Nerve Tissue Proteins; 0/Peptide Fragments; 0/Protein Isoforms; 0/Serum Amyloid P-Component; 0/Troponin T; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain; 148591-49-5/PTX3 protein; 9007-41-4/C-Reactive Protein; EC Kinase

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