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Associations of pentraxin 3 with cardiovascular disease: the Multi-Ethnic Study of Atherosclerosis
N S Jenny1, R S Blumenthal, R A Kronmal
1Department of Pathology, University of Vermont College of Medicine, Burlington, VT, USA.
Insights
Pentraxin 3 (PTX3) is a marker of vascular inflammation. Higher PTX3 levels in healthy adults are linked to increased cardiovascular disease (CVD) risk, including coronary heart disease events.
Area of Science:
- Cardiovascular Medicine
- Inflammation Biomarkers
- Atherosclerosis Research
Background:
- Pentraxin 3 (PTX3) is a potential specific marker for vascular inflammation.
- Limited data exist on PTX3 associations with cardiovascular disease (CVD) risk in healthy, multi-ethnic populations.
Purpose of the Study:
- To investigate the associations of PTX3 with CVD risk factors.
- To examine PTX3's relationship with subclinical CVD measures, coronary artery calcification (CAC), and incident CVD events.
Main Methods:
- Analysis of 2,838 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) cohort, free of prevalent CVD.
- Statistical adjustment for age, sex, ethnicity, and multiple CVD risk factors.
Main Results:
- PTX3 positively correlated with obesity, insulin resistance, hypertension, and carotid intima-media thickness.
- Elevated PTX3 levels were associated with the presence of CAC (RR 1.05).
- Higher PTX3 independently predicted increased risk of myocardial infarction (HR 1.51), combined CVD events (HR 1.23), and coronary heart disease (CHD) events (HR 1.33).
Conclusions:
- PTX3 is associated with CVD risk factors, subclinical CVD, and incident CHD events in apparently healthy adults.
- These findings suggest PTX3 reflects distinct inflammatory pathways compared to C-reactive protein (CRP).
- PTX3 may offer additional insights into atherosclerosis development and progression.
Objective:
Pentraxin 3 (PTX3) is probably a specific marker of vascular inflammation. However, associations of PTX3 with cardiovascular disease (CVD) risk have not been well studied in healthy adults or multi-ethnic populations. We examined associations of PTX3 with CVD risk factors, measures of subclinical CVD, coronary artery calcification (CAC) and CVD events in the Multi-Ethnic Study of Atherosclerosis.
Approach And Results:
Two thousand eight hundred and thirty-eight participants free of prevalent CVD with measurements of PTX3 were included in the present study. After adjustment for age, sex, and ethnicity, PTX3 was positively associated with age, obesity, insulin, systolic blood pressure, C-reactive protein (CRP), and carotid intima-media thickness (all P < 0.045). A one standard deviation increase in PTX3 level (1.62 ng mL(-1) ) was associated with the presence of CAC in fully adjusted models including multiple CVD risk factors (relative risk of 1.05; 95% confidence interval [CI] 1.01-1.08). In fully adjusted models, a standard deviation higher level of PTX3 was associated with an increased risk of myocardial infarction (hazard ratio [HR] 1.51; 95% [CI] 1.16-1.97), combined CVD events (HR 1.23; 95% [CI] 1.05-1.45), and combined CHD events (HR 1.33; 95% [CI] 1.10-1.60), but not stroke, CVD-related mortality, or all-cause death.
Conclusions:
In these apparently healthy adults, PTX3 was associated with CVD risk factors, subclinical CVD, CAC and incident coronary heart disease events independently of CRP and CVD risk factors. These results support the hypothesis that PTX3 reflects different aspects of inflammation than CRP, and may provide additional insights into the development and progression of atherosclerosis.
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