University of California, San Francisco, USA.
Am Heart J. 2012 Feb;163(2):274-9. doi: 10.1016/j.ahj.2011.11.007.
Pentraxin-3 (PTX3) is an inflammatory marker thought to be more specific to vascular inflammation than C-reactive protein (CRP). Whether PTX3 is independently associated with adverse events among persons with stable coronary heart disease (CHD), independently of CRP, and whether kidney dysfunction influences these associations are not known.
We evaluated the associations of baseline PTX3 levels with all-cause mortality, cardiovascular (CV) events (myocardial infarction, stroke, or CHD death), and incident heart failure (HF) during 37 months among ambulatory persons with stable CHD participating in the Heart and Soul Study. Cox proportional hazards models were adjusted for age, sex, race, hypertension, diabetes, smoking, and CRP.
Among 986 persons with stable CHD, each 1 unit increase in log PTX3 at baseline was associated with an 80% increased risk of all-cause mortality (hazard ratio [HR] 1.8, 95% CI 1.5-2.1), a 50% increased risk of CV events (HR 1.5, 95% CI, 1.2-1.9), and an 80% greater risk of incident HF (HR 1.8, 95% CI, 1.3-2.5). Further adjustment for estimated glomerular filtration rate (eGFR) attenuated these associations to 1.6 (1.3-1.9) for mortality, 1.3 (1.0-1.6) for CV events and 1.5 (1.1-2.1) for incident HF. Stratification by eGFR >60 mL/min per 1.73m(2) or <60 mL/min per 1.73m(2) did not affect these associations (P interaction > .3 for all outcomes).
Among persons with stable CHD, higher PTX3 concentrations were associated with increased risk for all-cause mortality, CV events, and incident HF independently of systemic inflammation. Adjustment for eGFR modestly attenuated these associations, suggesting that future studies of PTX3 should adjust for kidney function.
Pentraxin-3（PTX3）被认为比 C 反应蛋白（CRP）更能特异性地反映血管炎症，是一种炎症标志物。PTX3 是否与稳定型冠心病（CHD）患者的不良事件独立相关，是否独立于 CRP，以及肾功能障碍是否会影响这些关联，目前尚不清楚。
我们评估了基线 PTX3 水平与全因死亡率、心血管（CV）事件（心肌梗死、卒中和 CHD 死亡）和 37 个月内新发心力衰竭（HF）之间的相关性，该研究纳入了参加 Heart and Soul 研究的稳定型 CHD 门诊患者。Cox 比例风险模型调整了年龄、性别、种族、高血压、糖尿病、吸烟和 CRP。
在 986 名稳定型 CHD 患者中，基线时 log PTX3 每增加 1 个单位，全因死亡率的风险增加 80%（风险比[HR] 1.8，95%置信区间[CI] 1.5-2.1），CV 事件的风险增加 50%（HR 1.5，95%CI，1.2-1.9），新发 HF 的风险增加 80%（HR 1.8，95%CI，1.3-2.5）。进一步调整估算肾小球滤过率（eGFR）后，这些关联减弱至死亡率为 1.6（1.3-1.9）、CV 事件为 1.3（1.0-1.6）和新发 HF 为 1.5（1.1-2.1）。按 eGFR>60 mL/min/1.73m2 或<60 mL/min/1.73m2 分层，这些关联无影响（所有结局的 P 交互作用均>.3）。
在稳定型 CHD 患者中，较高的 PTX3 浓度与全因死亡率、CV 事件和新发 HF 的风险增加独立相关，而与全身炎症无关。调整 eGFR 后，这些关联略有减弱，提示未来对 PTX3 的研究应调整肾功能。
