Abstract 1705: Pentraxin 3, a Novel Plasma Inflammatory Marker, is Significantly Associated with Congestive Heart Failure
Background: Pentraxin 3 (PTX3) is a newly identified pentraxin superfamily member including C-reactive protein (CRP) and rapidly increases by inflammatory stimuli. Enhanced inflammation could be associated with pathophysiology of congestive heart failure (CHF). There is no data on its production by organs. We examined whether PTX3 could be produced in coronary circulation and to investigate clinical significance of plasma PTX3 levels in CHF patients.
Methods: We measured peripheral plasma levels of PTX3 and B-type natriuretic peptide (BNP) in 62 consecutive CHF patients (22 ischemic heart disease, 41 other causes) and 137 control subjects. We also measured plasma PTX3 levels at the aortic root and coronary sinus (CS) in 39 consecutive patients who received coronary angiography.
Results: The plasma levels of PTX3 at the CS is significantly higher than those at the aortic root (3.06 ± 1.70 versus 2.80 ± 1.55 ng/ml, p < 0.01). We found a significant correlation between the amount of PTX3 production in the coronary circulation and peripheral BNP levels (r = 0.489, p < 0.01). Peripheral plasma levels of PTX3 and BNP were significantly correlated (r = 0.509, p < 0.01). Patients with CHF had significantly higher levels of PTX3 compared with controls (median, interquartile range; CHF 4.72 ng/ml [2.52 to 6.80], control 2.14 ng/ml [1.59 to 3.27], p < 0.01). As New York Heart Association (NYHA) functional class raised, the peripheral PTX3 levels significantly increased (control; 2.67 ± 1.74, NYHA I; 3.39 ± 1.77, II; 5.22 ± 2.87, III/IV; 6.73 ± 3.15 ng/ml, p < 0.01). Multiple logistic regression analysis including age; PTX3; high-sensitivity CRP; BNP; and, ejection fraction (EF) all of which are significant factor to CHF by single logistic regression analysis, demonstrated that PTX3 and EF were significantly and independently contributed to the presence of CHF (PTX3: odds ratio [OR] 1.53; 95% confidence interval [CI] 1.23 to 1.88; p < 0.01; and, EF: OR 0.91; 95% CI 0.88 to 0.94; p < 0.01).
Conclusions: PTX3 is produced in the coronary circulation and significantly elevated in patients with CHF. PTX3, but not CRP, is the only plasma inflammatory marker associated with CHF, indicating that measurement of plasma PTX3 levels is clinically useful to assess inflammatory status of CHF.