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Higher Plasma Pentraxin-3 Level Predicts Adverse Clinical Outcomes in Patients With Coronary Artery Disease: A
Kejun Ding1, Zhewei Shi1, Caizhen Qian1
1Department of Cardiology, Zhuji Affiliated Hospital of Shaoxing University, Zhuji, China.
Insights
Higher plasma pentraxin-3 (PTX-3) levels in patients with coronary artery disease (CAD) are linked to an increased risk of mortality and major adverse cardiovascular events (MACEs). This association holds true across various CAD subtypes and follow-up durations.
Area of Science:
- Cardiovascular Medicine
- Biomarkers
- Clinical Research
Background:
- The prognostic value of plasma pentraxin-3 (PTX-3) in coronary artery disease (CAD) requires further clarification.
- Existing studies have yielded inconsistent findings regarding the association between PTX-3 and adverse cardiovascular outcomes.
Approach:
- A systematic meta-analysis of 16 cohort studies, encompassing 11,007 patients with CAD, was conducted.
- Studies included in this meta-analysis featured multivariate analyses to adjust for confounding factors.
- A random-effects model was employed to synthesize data and account for potential heterogeneity across studies.
Key Points:
- Elevated plasma PTX-3 levels were significantly associated with a higher risk of mortality (RR: 2.09) and major adverse cardiovascular events (MACEs) (RR: 1.80) in CAD patients.
- These associations remained consistent across different CAD subtypes, including ST-segment elevation myocardial infarction, non-ST-segment elevation acute coronary syndrome, and stable CAD.
- The prognostic significance of PTX-3 was observed irrespective of follow-up duration and adjustment for C-reactive protein (CRP).
Conclusions:
- Higher plasma PTX-3 levels serve as an independent predictor of poor prognosis in patients with coronary artery disease.
- The findings suggest that PTX-3 may offer valuable prognostic information in CAD, independent of disease classification or CRP levels.
Abstract:
Background: Association between plasma pentraxin-3 (PTX-3) and clinical outcomes in patients with coronary artery disease (CAD) remains not fully determined. An updated meta-analysis of cohort studies was performed to systematically evaluate the association. Methods: Cohort studies evaluating the association between plasma PTX-3 and adverse outcomes [mortality and major adverse cardiovascular events (MACEs)] in adults with CAD were identified by systematic search of PubMed, Embase, and Web of Science databases. Only studies with multivariate analysis were included. A random-effects model incorporating the potential intrastudy heterogeneity was used for the meta-analysis. Results: A total of 16 studies including 11,007 patients were included. Pooled results showed that patients with highest level of PTX-3 were independently associated with higher risk of mortality [adjusted risk ratio (RR): 2.09, 95% CI: 1.60 to 2.74, p < 0.001; I 2 = 50%] and MACEs (adjusted RR: 1.80, 95% CI: 1.43 to 2.28, p < 0.001; I 2 = 49%). Subgroup analyses showed that the associations between PTX-3 and poor prognosis in CAD were consistent in patients with ST-segment elevation myocardial infraction, non-ST-segment elevation acute coronary syndrome, and stable CAD (p < 0.05 for each subgroup). Besides, the association between PTX-3 and increased incidence of mortality and MACEs were consistent in short-term (within 1 year) and long-term (over 1 year) studies and in studies with or without adjustment of C-reactive protein (CRP) (p < 0.05 for each subgroup). Conclusion: Higher plasma PTX-3 is associated with poor prognosis in patients with CAD, which may be independent of the CAD subtype, follow-up durations, and adjustment of CRP.
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