Abstract
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.
Highlights
Introduction iationsThe inflammatory response has an important role during the acute phase and healing process after acute myocardial infarction (AMI) [1].C-reactive protein (CRP) is a member of the pentraxin protein family, and increased levels of CRP were observed several years ago in plasma from patients with acute infections, when it reacted with C polysaccharide from pneumococci [2,3]
We found no significan between compared groups for neprilysin or CRP, but for PTX3 significant differences were ferences between compared groups for neprilysin or CRP, but for PTX3 significant d ences were observed both for acute and 1–3 days after percutaneous coronary intervention (PCI) samples (Figure 4C,D)
We found that plasma levels of CRP and PTX3, but not neprilysin, were significantly elevated as compared with healthy donors
Summary
C-reactive protein (CRP) is a member of the pentraxin protein family, and increased levels of CRP were observed several years ago in plasma from patients with acute infections, when it reacted with C polysaccharide from pneumococci [2,3]. In acute inflammation, this protein is mainly synthesized by hepatocytes in response to pro-inflammatory cytokines released by macrophages and fat cells, especially interleukin-6 [3,4]. As CRP attaches to phosphocholine groups in the damaged myocardial cell membrane and activates the complement system, and enhances phagocytosis by macrophages and activates inflammation, it has been suggested to be an important player in the pathophysiology of MI [5,6].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
