Pentraxin 3 in primary percutaneous coronary intervention for ST elevation myocardial infarction is associated with early irreversible myocardial damage

Butt, Noreen; Bache-Mathiesen, Lena Kristin; Ushakova, Anastasia; Nordrehaug, Jan Erik; Jensen, Senn-Erik; Munk, Peter; Danchin, Nicolás; Dubois‐Randé, Jean‐Luc; Hansen, HS; Paganelli, Franck; Corvoisier, Philippe Le; Firat, Hüseyin; Erlinge, David; Atar, Dan; Larsen, Alf Inge

doi:10.1177/2048872620923641

Cited by 8 publications

(6 citation statements)

References 39 publications

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“…Today, CRP is a well-established biomarker associated with inflammation in cardiovascular disease. In accordance with previous findings [ 26 , 27 , 28 ], we observed that PTX3 had faster kinetics than CRP, with high values found already in the acute samples. In contrast to CRP, PTX3 is produced locally at the site of tissue trauma and inflammation.…”

Section: Discussionsupporting

confidence: 93%

“…However, as PTX3 was normalized 3 months after the PCI, it seems that the intervention helped to reverse the process leading to increased levels in the acute samples. There are previous studies that report increased levels of PTX3 in acute samples [ 27 , 28 ]. Others report increased PTX3 after PCI [ 9 , 30 , 31 ], and some report a reduction 1–3 days after PCI [ 9 , 27 ], but we have analyzed all three time points, which enables direct comparisons of the differences.…”

Section: Discussionmentioning

confidence: 99%

“…There are previous studies that report increased levels of PTX3 in acute samples [ 27 , 28 ]. Others report increased PTX3 after PCI [ 9 , 30 , 31 ], and some report a reduction 1–3 days after PCI [ 9 , 27 ], but we have analyzed all three time points, which enables direct comparisons of the differences.…”

Section: Discussionmentioning

confidence: 99%

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Dynamic Changes in Pentraxin-3 and Neprilysin in ST Segment Elevation Myocardial Infarction

et al. 2022

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Pentraxin-3 (PTX3) and neprilysin have been associated with increased morbidity and mortality in chronic inflammatory disease and heart failure, but these biomarkers have been studied less in patients with ST segment elevation myocardial infarction (STEMI). We investigated the dynamic changes in these biomarkers, as well as the well-known C-reactive protein (CRP), in STEMI patients. PTX3, neprilysin and CRP were measured in samples from 165 STEMI patients, collected at the acute stage, 1–3 days after and 3 months after percutaneous coronary intervention (PCI), and from 40 healthy donors. Patient survival was followed for approximately 8 years after the PCI. As compared with samples from healthy donors, plasma levels of CRP and PTX3 were significantly increased in the acute samples and 1–3 days after PCI, but not at 3 months. CRP levels peaked at 1–3 days, while PTX3 was similarly high in both acute and 1–3 days samples. For neprilysin, no significant differences were observed at the group level. We found no significant differences when comparing patients with patent versus occluded culprit vessels or between patients having a thrombus aspiration or not. However, we found a significant reduction in survival for individuals with PTX3 above the median, both for samples collected at the acute stage and 1–3 days after PCI (p = 0.0001 and p = 0.0008, respectively). For CRP, no significant differences were observed using this approach, but patients above the reference range for healthy donors in the acute samples showed significantly lower survival (p = 0.0476). Conclusions: Survival analysis suggests that PTX3 might be a promising marker to predict mortality in this patient population.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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Dynamic Changes in Pentraxin-3 and Neprilysin in ST Segment Elevation Myocardial Infarction

et al. 2022

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“…This result may be correlated with a higher median pentraxin-3 level in STEMI than in NSTEMI patients ( 31 ). Pentraxin-3 level was significantly correlated with infarct size ( 32 ) and thrombus burden ( 28 ). When we grouped the studies by the length of follow-up, the value of pentraxin-3 in predicting cardiac events was evident in studies with short-term follow-up than those with relatively long-term follow-up.…”

Section: Discussionmentioning

confidence: 99%

Utility of Elevated Pentraxin-3 Level as Inflammatory Marker for Predicting Adverse Outcomes in Patients With Acute Coronary Syndrome: A Meta-Analysis

Yang

He²,

Man³

et al. 2022

Front. Cardiovasc. Med.

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BackgroundVascular inflammation plays an important role in the pathogenesis and development of acute coronary syndrome (ACS). However, studies on the association between elevated pentraxin-3 level and adverse outcomes in patients with ACS have yielded controversial results. The purpose of this meta-analysis was to assess the value of elevated pentraxin-3 level as an inflammatory marker for predicting adverse outcomes in patients with ACS.MethodsTwo authors systematically searched the articles indexed in PubMed, Embase, CNKI, Wanfang, and VIP databases up to March 31, 2021. Studies reporting the association of elevated pentraxin-3 level at the acute phase with cardiovascular mortality, all-cause mortality, or cardiac events (cardiac death, non-fatal myocardial infarction, revascularization, or heart failure) in patients with ACS were included.ResultsA total of 8,775 ACS patients from 12 studies were identified and analyzed. When compared the lowest pentraxin-3 level, ACS patients with the highest pentraxin-3 level conferred an increased risk of cardiovascular mortality [risk ratio (RR) 2.10; 95% CI 1.44–3.06], all-cause mortality (RR 1.99; 95% CI 1.46–2.71), and cardiac events (RR 1.74; 95% CI 1.32–2.29), even after adjustment for some important confounders. Subgroup analysis indicated that the association of elevated pentraxin-3 level with cardiac events appeared to be stronger in ST-segment elevation myocardial infarction patients (RR 2.72; 95% CI 1.69–4.36) than in all patients with ACS (RR 1.59; 95% CI 1.10–2.29).ConclusionsElevated pentraxin-3 level is possibly an independent predictor of adverse outcomes in patients with ACS. Assessment of pentraxin-3 level at the acute phase can provide important information for early risk stratification of ACS.

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“…8 Butt et al. 9 investigated the kinetic of PTX3 as well as its correlation with inflammatory biomarkers and infarct size in 161 patients undergoing pPCI from the MITOCARE trial. PTX3 showed a steep increase in the early phase of STEMI (first 12 hours after admission) followed by a gradual decrease from 12 to 72 hours, therefore mimicking interleukin-6 and cardiac markers of necrosis, at variance from high-sensitive C-reactive protein (which continuously increased after 72 hours).…”

Section: Pentraxin 3 As a Novel Marker Of Myocardial Reperfusion Injurymentioning

confidence: 99%

The benefit and harm of treating STEMI: Between ischemia, bleeding, and reperfusion injury

Valgimigli

Gragnano

2020

European Heart Journal: Acute Cardiovascular Care

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Prompt referral for mechanical reperfusion with primary percutaneous coronary intervention (pPCI) is a pivotal step in the current treatment of ST-segment elevation myocardial infarction (STEMI). 1 The 'early open artery theory' has inspired and guided seminal trials and clinical practice over the last 30 years, and its application reduces in-hospital mortality after STEMI from 15% to approximately 3.5%. 2 Yet, what are the next steps to further improve STEMI outcomes? Percutaneous myocardial reperfusion is of unquestionable benefit, yet the ischemic relief provided by this intervention comes with some drawbacks. Bleeding complications related to access site negatively affect short-and long-term outcomes. 3,4 Thus, their risk should be minimised. Moreover, myocardial reperfusion after temporary coronary occlusion injuries the surviving myocardium-the so-called ischemia/reperfusion (I/R) injury-and effective strategies for its assessment and/or prevention lack in practice. Two reports in the Journal offer new data on these issues that still hamper the contemporary management of STEMI (Figure 1).

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Pentraxin 3 in primary percutaneous coronary intervention for ST elevation myocardial infarction is associated with early irreversible myocardial damage

Cited by 8 publications

References 39 publications

Dynamic Changes in Pentraxin-3 and Neprilysin in ST Segment Elevation Myocardial Infarction

Dynamic Changes in Pentraxin-3 and Neprilysin in ST Segment Elevation Myocardial Infarction

Utility of Elevated Pentraxin-3 Level as Inflammatory Marker for Predicting Adverse Outcomes in Patients With Acute Coronary Syndrome: A Meta-Analysis

The benefit and harm of treating STEMI: Between ischemia, bleeding, and reperfusion injury

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