Abstract

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.

Highlights

  • Acute coronary syndrome (ACS) refers to a group of conditions, namely, ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina

  • Two reviewers independently searched the articles indexed in PubMed, Embase, CNKI, Wanfang, and VIP databases up to March 31, 2021, using the following keywords in combination: “pentraxin-3” AND “acute coronary syndrome” odds ratio (OR) “acute myocardial infarction” OR “unstable angina.”

  • A random-effect metaanalysis showed that elevated pentraxin-3 level was associated with a higher risk of cardiovascular mortality (RR 2.10; 95% CI 1.44–3.06; I2 = 58.4%; P = 0.065; Figure 4)

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Summary

Introduction

Acute coronary syndrome (ACS) refers to a group of conditions, namely, ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina. Apart from its diagnostic value [10, 11], several studies [12,13,14,15,16,17,18,19] have examined the role of pentraxin-3 level as a predictor of adverse outcomes in patients with ACS. Vascular inflammation plays an important role in the pathogenesis and development of acute coronary syndrome (ACS). 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

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