Pentraxin 3, a new marker for vascular inflammation, predicts adverse clinical outcomes in patients with heart failure

Abstract

Pentraxin 3 (PTX3) is a novel inflammatory marker produced by endothelial cells, smooth muscle cells, and macrophages. The purpose of the present study was to examine the clinical significance of plasma PTX3 levels in patients with heart failure. We measured the plasma PTX3 levels in 196 patients with heart failure and 60 control subjects without heart failure by sandwich enzyme-linked immunosorbent assay. Patients were prospectively followed during a median follow-up period of 655 days with the end points of cardiac death or progressive heart failure requiring rehospitalization. Plasma PTX3 concentrations were higher in patients with heart failure than in control subjects (P < .0001) and increased as the severity of New York Heart Association functional class advanced (P < .0001). A total of 63 cardiac events occurred during a follow-up period, and cardiac event-free rate was markedly lower in patients with high PTX3 levels than in those with normal PTX3 levels (44.7% vs 89.2%, P < .0001). The multivariate Cox proportional hazard analysis demonstrated that the plasma PTX3 level, but not the high-sensitive C-reactive protein, was the independent predictor of cardiac events (hazard ratio 1.20, 95% CI 1.03-1.40, P = .0162). Patients were divided into 4 groups based on plasma PTX3 values from first to fourth quartile. The highest fourth quartile of plasma PTX3 levels was associated with the highest risk of cardiac events (9.23-fold compared with the first quartile). The plasma PTX3 level provides important prognostic information for the risk stratification of patients with heart failure.