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Prognostic Value of Pentraxin-3 Change After Primary Percutaneous Coronary Intervention in Patients with ST-Segment
Sheng-Yu Li1, Lei Liu1, Ding-Kun Wang1
1Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China.
Insights
The increase in pentraxin-3 (PTX3) levels 24 hours after primary percutaneous coronary intervention (pPCI) may predict major adverse cardiac cerebral events (MACCEs) in ST-segment elevation myocardial infarction (STEMI) patients within one year, particularly for revascularization.
Area of Science:
- Cardiology
- Biomarkers
- Acute Coronary Syndromes
Background:
- ST-segment elevation myocardial infarction (STEMI) remains a leading cause of cardiovascular mortality.
- Pentraxin-3 (PTX3) has emerged as a potential biomarker in coronary heart disease.
- Understanding PTX3 dynamics post-intervention is crucial for risk stratification.
Purpose of the Study:
- To investigate the dynamic changes of PTX3 levels following primary percutaneous coronary intervention (pPCI) in STEMI patients.
- To evaluate the prognostic value of these PTX3 changes for major adverse cardiac cerebral events (MACCEs).
Main Methods:
- A prospective cohort study involving 350 STEMI patients undergoing pPCI.
- Plasma PTX3 levels were measured at admission, 24 hours, and 5 days post-pPCI.
- One-year follow-up for MACCEs, including cardiac events and cerebral events.
Main Results:
- PTX3 levels peaked at 24 hours and decreased by 5 days post-pPCI.
- A higher increase in PTX3 from admission to 24 hours (ΔPTX3) was significantly associated with increased MACCEs (P=0.001).
- High ΔPTX3 independently predicted MACCEs (adjusted HR=2.010) and revascularization (HR=2.094).
Conclusions:
- The magnitude of PTX3 increase 24 hours after pPCI is a potential independent predictor of 1-year MACCEs in STEMI patients.
- This biomarker change may be particularly valuable for identifying patients requiring coronary revascularization.
Purpose:
So far, ST-segment elevation myocardial infarction (STEMI) is still the main cause of morbidity and mortality of cardiovascular diseases worldwide. Recent studies showed that pentraxin-3 (PTX3) was related to the early diagnosis and prognosis of coronary heart disease. This study aimed to investigate the dynamical change of PTX3 after primary percutaneous coronary intervention (pPCI) in STEMI patients and its prognostic value.
Patients And Methods:
In this prospective cohort study, a total of 350 patients were enrolled. The plasma level of PTX3 was measured at admission, 24-hour and 5-day after pPCI. The primary endpoint was the incidence of major adverse cardiac cerebral events (MACCEs) during 1-year follow-up.
Results:
Compared with the admission, PTX3 levels were significantly increased at 24 hours, and decreased at 5 days after pPCI in the whole cohort. PTX3 levels at these three time points were not significantly different between the patients with and without MACCEs. Notably, the change in PTX3 from admission to post-pPCI 24-hour (ΔPTX3) was higher in patients with MACCEs (112.83 vs 17.94 ng/dl, P = 0.001). The ROC curves showed that the cut-off value was 29.22 ng/dl and the area under curves was 0.622 (95% CI: 0.554-0.690, p = 0.001). Multivariable cox regression models revealed that the high ΔPTX3 group was an independent predictor of MACCEs (adjusted HR = 2.010, 95% CI = 1.280-3.186, p = 0.003). The higher ΔPTX3 group had significantly higher incidences of revascularization (HR = 2.094, 95% CI: 1.056-4.150, p = 0.034) and composite MACCEs (HR = 2.219, 95% CI: 1.425-3.454, p < 0.001). However, the change of PTX3 level from admission to post-pPCI 5-day had no independently predictive value.
Conclusion:
The higher increase of PTX3 level 24-hour after pPCI appeared to have a potential value in independently predicting the incidence of 1-year MACCEs in STEMI patients, especially for coronary revascularization.
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