Befekadu Rahel, Grenegård Magnus, Larsson Anders, Christensen Kjeld, Ramström Sofia
Department of Laboratory Medicine, Section for Clinical Immunology and Transfusion Medicine, Örebro University Hospital, 70185 Örebro, Sweden.
Cardiovascular Research Centre, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, 70185 Örebro, Sweden.
Biomedicines. 2022 Jan 26;10(2):275. doi: 10.3390/biomedicines10020275.
Pentraxin-3 (PTX3) and neprilysin have been associated with increased morbidity and mortality in chronic inflammatory disease and heart failure, but these biomarkers have been studied less in patients with ST segment elevation myocardial infarction (STEMI). We investigated the dynamic changes in these biomarkers, as well as the well-known C-reactive protein (CRP), in STEMI patients. PTX3, neprilysin and CRP were measured in samples from 165 STEMI patients, collected at the acute stage, 1-3 days after and 3 months after percutaneous coronary intervention (PCI), and from 40 healthy donors. Patient survival was followed for approximately 8 years after the PCI. As compared with samples from healthy donors, plasma levels of CRP and PTX3 were significantly increased in the acute samples and 1-3 days after PCI, but not at 3 months. CRP levels peaked at 1-3 days, while PTX3 was similarly high in both acute and 1-3 days samples. For neprilysin, no significant differences were observed at the group level. We found no significant differences when comparing patients with patent versus occluded culprit vessels or between patients having a thrombus aspiration or not. However, we found a significant reduction in survival for individuals with PTX3 above the median, both for samples collected at the acute stage and 1-3 days after PCI ( = 0.0001 and = 0.0008, respectively). For CRP, no significant differences were observed using this approach, but patients above the reference range for healthy donors in the acute samples showed significantly lower survival ( = 0.0476). Conclusions: Survival analysis suggests that PTX3 might be a promising marker to predict mortality in this patient population.
五聚素3（PTX3）和中性内肽酶与慢性炎症性疾病和心力衰竭的发病率及死亡率升高有关，但在ST段抬高型心肌梗死（STEMI）患者中对这些生物标志物的研究较少。我们调查了STEMI患者中这些生物标志物以及广为人知的C反应蛋白（CRP）的动态变化。在165例STEMI患者的样本中测量了PTX3、中性内肽酶和CRP，这些样本分别在急性期、经皮冠状动脉介入治疗（PCI）后1 - 3天和3个月时采集，同时采集了40例健康供者的样本。PCI后对患者的生存情况进行了约8年的随访。与健康供者的样本相比，急性期和PCI后1 - 3天的样本中CRP和PTX3的血浆水平显著升高，但在3个月时未升高。CRP水平在1 - 3天达到峰值，而PTX3在急性期和1 - 3天的样本中同样较高。对于中性内肽酶，在组水平上未观察到显著差异。比较罪犯血管通畅与闭塞的患者或进行血栓抽吸与未进行血栓抽吸的患者时，我们未发现显著差异。然而，我们发现，在急性期和PCI后1 - 3天采集的样本中，PTX3高于中位数的个体生存率显著降低（分别为 = 0.0001和 = 0.0008）。对于CRP，采用这种方法未观察到显著差异，但急性期样本中高于健康供者参考范围的患者生存率显著降低（ = 0.0476）。结论：生存分析表明，PTX3可能是预测该患者群体死亡率的一个有前景的标志物。
