Abstract 12218: Pentraxin 3 is a Significant Inflammatory Maker Predicting Future Cardiovascular Events in Patients with Heart Failure with Normal Left Ventricular Ejection Fraction
Backgrounds Pentraxin 3 (PTX3) is a new inflammatory maker and produced by various cell types including vasculature and heart. We have shown that PTX3 is significantly elevated in patients with heart failure with normal left ventricular ejection fraction (HFNEF) and an independent inflammatory marker correlated with the presence of HFNEF. We investigate whether plasma levels of PTX3 could predict occurrence of future cardiovascular (CV) events in patients with HFNEF.
Methods We conducted a prospective cohort study of 218 HFNEF patients (age 71.1±10.1, male 53%) with measuring plasma inflammatory markers (PTX3, high-sensitivity C-reactive protein [hsCRP], tumor necrosis factor-α and interleukin-6) and B-type natriuretic peptide (BNP) and followed CV events, which were a composite of CV death, non-fatal myocardial infarction or ischemic stroke, unstable angina, hospitalization for HF, or coronary revascularization.
Results Simple linear regression analysis revealed a significant positive correlation between levels of PTX3 and BNP (r=0.376, P<0.001). A total of 64 patients had a CV event (mean follow-up; 28 months). Kaplan-Meier analysis demonstrated significantly higher probability of CV events in the higher PTX3 group (>3.0ng/ml: median) than in the lower PTX3 group (log rank test P<0.001). Multivariate Cox hazard analysis with significant factors by univariate analysis identified PTX3 (hazard ratio [HR] 1.15, 95% confidence interval [CI] 1.01-1.30, P<0.05), and BNP (HR 1.07, 95%CI 1.01-1.13, P<0.05), but not hsCRP, as independent predictors of the future CV events. Among inflammatory biomarkers and BNP, PTX3 was an only significant inflammatory predictor (HR 1.18, 95%CI 1.02-1.38, P<0.05). Multivariate Cox analysis with the forced inclusion model with the previously identified HFNEF prognostic factors in I-PRESERVE study (age, diabetes, New York Heart Association class, HF hospitalization history, and LVEF) demonstrated PTX3 as the significant predictor (HR 1.22, 95%CI 1.09-1.37, P<0.001).
Conclusion Elevated plasma levels of PTX3, but not other inflammatory markers including hsCRP, independently correlated with the future CV events in patients with HFNEF. PTX3 could provide useful information in managing of patients with HFNEF.
- © 2012 by American Heart Association, Inc.