Abstract
Objective: Coronary Artery Disease (CAD) would continue to concern medical society in the foreseeable future. Determining the extent of coronary luminal stenosis is a key factor in management of CAD. Methods presently used are costly and pose certain dangers, ranging from nephrotoxicity to death. Long Pentraxin or Pentraxin-3 (PTX3) has been used to predict survival or atherosclerotic process, but not to identify coronary stenosis. Calcium Score has been used to this end with some success. Methods: Individuals with chronic stable angina, without evidence of Myocardial Infarction (MI), who were categorized as intermediate-risk after completing a treadmill exercise test, according to Duke Protocol, underwent cardiac catheterization. In addition, blood samples were drawn for coronary sinus PTX3, and also PTX3, uric acid, high-sensitivity C-reactive protein (hs-CRP), cholesterol, glucose and High-Density Lipo-protein (HDL) in peripheral circulation. Calcium Scores were calculated using Agatston Score and non-contrast multi-slice CT scan. Participants were divided according to the number of stenotic coronary arteries (patent, one-, two-and three-vessel disease). Results: We found that PTX3 levels in coronary sinus and femoral vein correlated with each other, after log-transforming the values. Also we found that PTX3 levels and Calcium Scores differed among individuals with triple-vessel involvement and individuals without significant stenosis in any of coronary arteries. No significant differences were observed, regarding hs-CRP levels. Conclusion: PTX3 levels in periphery correlate with those in coronary arteries, and this variable can be measured with a less invasive procedure. In addition to Calcium Score, PTX3 levels are different in our four groups. The combined contribution of PTX3 and calcium score may help us identify individuals with significant coronary artery stenosis without needing to perform cardiac catheterization in a select group of patients.
Highlights
Coronary Artery Disease (CAD) is a leading cause of mortality worldwide [1]
We found that PTX3 levels and Calcium Scores differed among individuals with triple-vessel involvement and individuals without significant stenosis in any of coronary arteries
Atherosclerosis of coronary arteries is by far the main etiology of Ischemic Heart Disease (IHD) and plaque disruption superimposed by thrombosis is the major cause of Acute Coronary Syndromes (ACS) including Unstable Angina (UA) and Myocardial Infarction (MI) and sudden death [2,3]
Summary
Atherosclerosis of coronary arteries is by far the main etiology of Ischemic Heart Disease (IHD) and plaque disruption superimposed by thrombosis is the major cause of Acute Coronary Syndromes (ACS) including Unstable Angina (UA) and Myocardial Infarction (MI) and sudden death [2,3]. H. Haybar et al / World Journal of Cardiovascular Diseases 3 (2013) 433-441 determine the prognosis of chronic stable angina when the diagnosis is uncertain [4]. In addition to helping quantify ischemia severity [5], Duke Score enables us to postpone cardiac catheterization in patients classified as low-risk. Since patients in the intermediate-risk group are usually referred for cardiac catheterization, which is costly, needs expertise and is potentially hazardous, a search is going on to find newer methods and prediction models, with respect to coronary artery involvement [6,7,8,9,10]. Considering that traditional models for atherosclerosis risk-stratification mainly determine the long-term risk of cardiac events, there is a trend towards biomarkers and their use for assessing short-term risk of cardiovascular events [11]
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