Association of plasma pentraxin 3 concentration with angiographic and clinical outcomes in patients with acute ST‐segment elevation myocardial infarction treated by primary angioplasty

Abstract

Objective: To evaluate the association of plasma long pentraxin 3 (PTX3) concentration with angiographic and clinical outcomes in patients with acute ST-segment elevation myocardial infarction (STEMI) treated by primary angioplasty. Background: Whether concentration of PTX3, a sensitive marker of inflammation, associates with angiographic and clinical outcomes in STEMI patients treated by primary angioplasty is unknown. Methods: We prospectively enrolled 335 consecutive patients with acute STEMI undergoing primary angioplasty. Blood samples for plasma PTX3 measurement were drawn in all patients at the emergency department before primary angioplasty, and were measured by ELISA method. Results: The median PTX3 concentrations were higher in patients with thrombus burden grade 4 and 5 versus grade <4 on initial coronary angiogram (0.29 ng/ml vs. 0.24 ng/ml, p = .02), thrombolysis in myocardial infarction (TIMI) grade <3 vs. TIMI grade-3 flow after primary angioplasty (0.31 ng/ml vs. 0.24 ng/ml, p < .001), incomplete versus complete ST-segment resolution within 12 hr after angioplasty (0.29 ng/ml vs. 0.22 ng/ml, p = .001) and in patients who did not survive versus those who survived at 30 days (0.44 ng/ml vs. 0.26 ng/ml, p = .001). A linear correlation was observed between PTX3 concentration and baseline leukocyte count (Spearman correlation = 0.21, p < .001). After adjustment for laboratory and selected clinical variables, patients in the highest quartile of PTX3 concentration (≥0.4 ng/ml) were associated with increased risk of 30-day mortality (hazard ratio = 11.83; 95% confidence interval = 1.52-92.27, p = .01). Conclusion: This study suggests that higher plasma PTX3 concentration associates with worse angiographic and clinical outcomes in STEMI patients treated by primary angioplasty.

Performance of Primary Angioplasty for STEMI during the COVID-19 Outbreak

“…Primary PCI procedure in our hospital has been previously described. 6 In brief, all patients were pretreated with 160 to 320 mg acetylsalicylic acid and 600 mg clopidogrel or 180 mg ticagrelor (peroral). Unfractionated heparin (100 IU/kg) was administered intravenously in the catheterization laboratory after sheath insertion.…”

Association of microRNA-224-3p and microRNA-155-5p expressions with plasma long pentraxin 3 concentration and coronary microvascular obstruction following primary angioplasty for acute ST-segment elevation myocardial infarction

“…Primary PCI procedure was previously described [ 3 ]. In brief, all patients were pre-treated with 160–320 mg acetylsalicylic acid and 600 mg clopidogrel or 180 mg ticagrelor orally.…”

“…As previously described [ 3 ], PTX3 was assayed with a commercial Human PTX3 ELISA kit (San Diego, California, USA) by dedicated molecular biology laboratory personnel and blinded to the characteristics of the patients.…”

“…Coronary microvascular obstruction (MVO) during primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) associates with a worse clinical outcome [ 1 ]. Interestingly, the genetic profile and PTX3 concentration have been known to be associated with coronary MVO [ 2 , 3 ]. Understanding the basic molecular mechanism of MVO is essential for possible therapeutic target, e.g., identifying the specific microRNA (miR) that associates with coronary MVO.…”

“…Of these, miR-224 and miR-155 expression were acutely increased > twofold following an inflammation stimuli [ 4 ]. It is known that PTX3 protein expression causing a procoagulant environment in the endothelial cells [ 6 ], thus higher plasma PTX3 concentration has been known to be associated with thrombus grade 4 or 5 in patients with acute STEMI [ 3 ]. However, whether miR-224-3p and miR-155-5p associate with PTX3 concentration and coronary MVO following primary angioplasty for patients with acute STEMI are unknown.…”