Abstract 12033: Changes in Plasma Pentraxin 3 Level Within Six Months After Percutaneous Coronary Intervention Predict Target Lesion Revascularization
Background: Percutaneous coronary intervention (PCI) induces a significant inflammatory reaction in the injured vessel wall, leading to the development of in-stent restenosis. Pentraxin 3 (PTX3), an inflammatory marker, is highly expressed locally in atherosclerotic lesions and has been implicated as a predictor of adverse clinical outcomes for acute coronary syndrome. However, the impact of plasma PTX3 level on in-stent restenosis and subsequent target lesion revascularization (TLR) rate has yet to be fully elucidated. The aim of this study was to clarify whether PTX3 levels and changes over time can predict TLR.
Methods: Participants comprised 56 patients with coronary artery disease (14 patients with stable angina, 42 patients with unstable angina; mean age, 67 ± 9 years) who underwent PCI and 6-month follow-up coronary angiography. Plasma PTX3 levels were measured at baseline and follow-up, and percentage changes in PTX3 levels were calculated. Elevations in PTX3 level >20% were defined as rising PTX3. Patients were divided into groups with (n = 14) or without rising PTX3 (n = 42). Clinical background, procedural data of PCI, and TLR rate were compared between groups.
Results: No significant differences in prevalence of unstable angina, PTX3 level at baseline, use of drug-eluting stents, or proportion of type B2/C lesion were identified between patients both with and without rising PTX3. In contrast, the rate of TLR was significantly higher in patients with rising PTX3 (35.7%) than in those without (9.5%, p = 0.021). Univariate logistic regression analysis showed that white blood cell count at baseline, fasting plasma glucose level at baseline, stent diameter, PTX3 levels at baseline and follow-up, and presence of rising PTX3 correlated with TLR. In multivariate logistic analysis using those factors, the only independent predictor of TLR was presence of rising PTX3 (odds ratio, 0.137; 95% confidence interval 0.027-0.696; p = 0.017).
Conclusions: Elevated PTX3 levels during follow-up may be useful for predicting TLR. This might provide insight into the roles of PTX3 in the process of developing in-stent restenosis.
- © 2013 by American Heart Association, Inc.