Plasma Pentraxin-3 Combined with Plaque Characteristics Predict Cardiovascular Risk in ST-Segment Elevated Myocardial Infarction: An Optical Coherence Tomography Study
Ying Wang,1 Xiaoxiao Zhao,1 Peng Zhou,1 Chen Liu,1 Zhaoxue Sheng,1,2 Jiannan Li,1 Jinying Zhou,1 Runzhen Chen,1 Yi Chen,1 Li Song,1 Hanjun Zhao1 *, Hongbing Yan3 𪇞partment of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College &a...
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| Formato: | article |
| Lenguaje: | EN |
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Dove Medical Press
2021
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| Acceso en línea: | https://doaj.org/article/b73dafe2076744979bedddb9448aad60 |
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| Sumario: | Ying Wang,1 Xiaoxiao Zhao,1 Peng Zhou,1 Chen Liu,1 Zhaoxue Sheng,1,2 Jiannan Li,1 Jinying Zhou,1 Runzhen Chen,1 Yi Chen,1 Li Song,1 Hanjun Zhao1 *, Hongbing Yan3 𪇞partment of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; 2Department of Cardiology, China-Japan Friendship Hospital, Beijing, People’s Republic of China; 3Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, People’s Republic of China* These authors contributed equally to this workCorrespondence: Hongbing YanDepartment of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences, No. 12, Langshan Road, Xili Street, Nanshan District, Shenzhen, 518000, People’s Republic of ChinaTel +86-10-88322285Email hbyanfuwai2018@163.comHanjun ZhaoDepartment of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences, No. 167 Beilishi Road, Xicheng District, Beijing, 100037, People’s Republic of ChinaTel +86-15210020808Email 15210020808@163.comBackground: Culprit‑plaque morphology [plaque rupture (PR) and plaque erosion (PE) identified by optical coherence tomography (OCT)] and biomarker of vascular inflammation, pentraxin-3 (PTX3), have been reported to influence clinical outcomes in coronary diseases. We aimed to investigate the prognostic implication of culprit-plaque morphology and plasma PTX3 for major adverse cardiovascular events (MACE) in patients with ST-segment elevation myocardial infarction (STEMI).Methods: A total of 236 patients were enrolled and divided into four groups: PE/low-PTX3 (n = 57), PE/high-PTX3 (n = 47), PR/low-PTX3 (n = 78) and PR/high-PTX3 (n = 54). MACE was defined as the composite of all-cause death, recurrence of myocardial infarction, stroke and unplanned revascularization of any coronary artery.Results: During the follow-up of 1.9 years, a total of 40 (16.9%) MACE were observed: 5.3% (3 patients) among patients with PE/low-PTX3, 21.3% (10 patients) among patients with PE/high-PTX3, 17.9% (14 patients) among patients with PR/low-PTX3 and 24.1% (13 patients) among patients with PR/high-PTX3 (Log rank P = 0.013). In fully adjusted analyses, patients with high-PTX3 were associated with higher MACE risk (HR: 2.40, 95% CI: 1.26– 4.57, P = 0.008). Patients with PR/high-PTX3 (HR: 5.63, 95% CI: 1.57– 20.16, P = 0.008) and PE/high-PTX3 (HR: 5.44, 95% CI: 1.46– 20.29, P = 0.012) presented higher MACE risk than those with PE/low-PTX3. Adding plasma PTX3 levels and PR to the risk prediction model increased the area under curves to 76.1% (95% CI: 67.6– 84.5%) and the NRI (28.1%, 95% CI: 0.3– 48.3%, P=0.040) and IDI (2.4%, 95% CI: 0.1– 12.9%, P = 0.040).Conclusion: Patients with PR/high-PTX3 and PE/high-PTX3 presented a poorer prognosis than those with PE/low-PTX3. Combining the culprit-plaque morphology with PTX3 enhanced the predictive ability for MACE and contributed to better identification of high-risk patients.Trial Registration Number: This study is registered at clinical trials.gov as NCT03593928.Keywords: pentraxin-3, plaque rupture, optical coherence tomography, cardiovascular risk, ST-segment elevation myocardial infarction |
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