Prognostic Value of Pentraxin-3 Change After Primary Percutaneous Coronary Intervention in Patients with ST-Segment Elevation Myocardial Infarction

Figures & data

Figure 1 The flow chart of study subject enrollment.

Abbreviations: CBD, Cardiovascular Center of Beijing Friendship Hospital Database; STEMI, ST segment elevation myocardial infarction; pPCI, primary percutaneous coronary intervention; PTX3, pentraxin-3; MACCEs, major adverse cardiac cerebral events.

Table 1 Baseline Characteristics of Patients with and without MACCEs

	All Patients (n=350)	With MACCEs (n=90)	Without MACCEs (n=260)	P-value
Male gender	264 (75.4)	65 (72.2)	199 (76.5)	0.412
Age, years	62.25±12.57	64.98±11.42	61.30±12.83	0.017
BMI, kg/m^2	25.90±3.62	25.45±3.58	26.05±3.63	0.180
SBP, mmHg	125.01±21.77	124.87±22.17	125.06±21.67	0.943
DBP, mmHg	74.30±14.15	72.64±14.20	74.88±14.11	0.198
Medical history
Current smoker	183 (52.3)	49 (54.4)	134 (51.5)	0.634
Hypertension	217 (62.0)	61 (67.8)	156 (60.0)	0.190
Diabetes mellitus	106 (30.3)	33 (36.7)	73 (28.1)	0.126
Stroke	33 (9.4)	12 (13.3)	21 (8.1)	0.141
Previous AMI	64 (18.3)	24 (26.7)	40 (15.4)	0.017
Previous PCI/CABG	51 (14.6)	22 (24.4)	29 (11.2)	0.002
Laboratory values
WBC, 10^9/L	9.91±3.08	9.73±3.13	9.97±3.07	0.519
HsCRP, mg/L	11.24±12.16	11.52±11.56	11.14±12.39	0.807
Creatinine, umol/L	75.22±24.30	76.97±27.07	74.61±23.29	0.428
TC, mmol/L	4.58±1.12	4.29±1.22	4.70±1.07	0.003
TGs, mmol/L	1.44 (1.11, 2.03)	1.39 (1.04, 1.96)	1.45 (1.12, 2.04)	0.548
HDL-c, mmol/L	1.04±0.27	0.99±0.29	1.06±0.26	0.029
LDL-c, mmol/L	2.68±0.80	2.48±0.89	2.75±0.76	0.006
Peak CK, U/L	1903.94±1559.07	2114.18±2033.08	1830.60±1352.64	0.138
Peak CKMB, U/L	214.97±164.80	228.42±175.54	210.39±161.08	0.382
Peak cTnI, ng/mL	24.01±18.09	25.03±19.02	23.67±17.79	0.548
Peak NT-proBNP, pg/mL	1595 (673, 3252)	2394 (1105, 4285)	1410 (604, 2820)	0.001
Echocardiography
LA, cm	3.70±0.43	3.75±0.40	3.68±0.45	0.208
LVESD, cm	3.63±0.48	3.69±0.53	3.60±0.47	0.147
LVEDD, cm	5.17±0.44	5.17±0.46	5.17±0.43	0.947
LVESV, mL	56.95±18.89	59.88±20.89	55.93±18.08	0.087
LVEDV, mL	129.19±25.95	129.60±27.64	129.04±25.39	0.860
LVESVI, mL/m^2	66.17±21.90	71.55±24.11	64.30±20.80	0.007
LVEDVI, mL/m^2	150.19±30.84	155.41±31.65	148.37±30.40	0.062
LVEF, %	56.44±8.24	54.74±8.45	57.02±8.10	0.024
LVEF≥50%	264 (75.6)	62 (68.9)	202 (78.0)	0.083
Angiography findings
Multi-vessel/LM	318 (90.9)	86 (95.6)	232 (89.2)	0.073
Slow/no-reflow	11 (3.3)	3 (3.8)	8 (3.2)	0.816
Syntax score	13.42±6.02	15.02±6.32	12.87±5.83	0.003
Risk scores
GRACE score	156.59±34.18	165.12±35.36	153.63±33.32	0.006
TIMI score	3.95±2.30	4.46±2.52	3.78±2.20	0.016
Killip class II–IV	91 (26.0)	30 (33.3)	61 (23.5)	0.066
Anterior wall MI	180 (51.4)	51 (56.7)	129 (49.6)	0.249
Treatment pre-admission
Antiplatelet agent	113 (32.3)	33 (36.7)	80 (30.8)	0.302
ACEI/ARB	79 (22.6)	26 (28.9)	53 (20.4)	0.096
Beta-blocker	33 (9.4)	10 (11.1)	23 (8.8)	0.526
Statin	43 (12.3)	17 (18.9)	26 (10.0)	0.027

Note: Values are presented as mean±SD, median (IQR) or number (%).

Abbreviations: BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; AMI, acute myocardial infarction; PCI, percutaneous coronary intervention; CABG, coronary artery bypass graft; WBC, white blood cell; HsCRP, high sensitivity C reactive protein; TC, total cholesterol; TGs, triglycerides; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; cTnI, cardiac troponin I; NT-proBNP, N-terminal prohormone brain natriuretic peptide; LA, left atrium; LVESD, left ventricular end systolic diameter; LVEDD, left ventricular end diastolic diameter; LVESV, left ventricular end systolic volume; LVEDV, left ventricular end diastolic volume; LVESVI, left ventricular end systolic volume index; LVEDVI, left ventricular end diastolic volume index; LVEF, left ventricular ejection fraction; LM, left main coronary artery; GRACE, Global Registry of Acute Coronary Events; TIMI, The Thrombolysis in Myocardial Infarction; ACEI/ARB, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker.

Figure 2 Dynamical change of PTX3 concentration at admission, 24 hours after pPCI and 5 days after pPCI in STEMI patients with and without MACCEs. ^#P < 0.05 vs at admission.

Abbreviations: PTX3, pentraxin-3; pPCI, primary percutaneous coronary intervention.

Figure 3 Correlation between ΔPTX3 and peak NT-proBNP (A), LVEF (B), Syntax score (C), GRACE score (D) and TIMI score (E).

Abbreviations: PTX3, pentraxin-3; ΔPTX3, the change in PTX3 from admission to post-pPCI 24-hour; NT-proBNP, N-terminal prohormone brain natriuretic peptide; LVEF, left ventricular ejection fraction; GRACE, Global Registry of Acute Coronary Events; TIMI, The Thrombolysis in Myocardial Infarction.

Figure 4 The receiver operating characteristic (ROC) curve of the ΔPTX3 as a marker to predict MACCEs.

Abbreviations: PTX3, pentraxin-3; ΔPTX3, the change in PTX3 from admission to post-pPCI 24-hour.

Table 2 Univariate and Multivariate Cox Regression Analysis of MACCEs in All Patients

	Univariate Analysis	P-value	Multivariate Analysis	P-value
	HR (95% CI)		HR (95% CI)
ΔPTX3 ≥29.22, ng/dl	2.219 (1.425–3.454)	<0.001	2.010 (1.280–3.186)	0.003
Male gender	1.228 (0.774–1.948)	0.383	1.302 (0.761–2.228)	0.336
Age, years	1.020 (1.003–1.037)	0.019	1.010 (0.991–1.030)	0.288
Previous PCI/CABG	2.282 (1.409–3.694)	0.001	1.819 (1.082–3.059)	0.024
HDL-c, mmol/L	0.455 (0.224–0.926)	0.030	0.374 (0.137–1.016)	0.054
LDL-c, mmol/L	0.661 (0.493–0.886)	0.006	0.846 (0.621–1.153)	0.290
Peak NT-proBNP, pg/mL	1.000 (1.000–1.000)	0.047	1.000 (1.000–1.000)	0.794
LVEF, %	0.058 (0.006–0.611)	0.018	0.070 (0.005–0.919)	0.043
Statin	1.783 (1.051–3.023)	0.032	1.276 (0.701–2.323)	0.425

Abbreviations: PCI, percutaneous coronary intervention; CABG, coronary artery bypass graft; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; NT-proBNP, N-terminal prohormone brain natriuretic peptide; LVEF, left ventricular ejection fraction; PTX3, pentraxin-3; ΔPTX3, the change in PTX3 from admission to post-pPCI 24-hour.

Table 3 Clinical Events in Low ΔPTX3 Group and High ΔPTX3 Group During 1-Year Follow-Up

	ΔPTX3<29.22 ng/dl (n=169)	ΔPTX3≥29.22 ng/dl (n=181)	HR(95% CI)	P-value
MACCEs (%)	29 (17.2)	61 (33.7)	2.219 (1.425–3.454)	<0.001
Non-fatal MI (%)	4 (2.4)	3 (1.7)	0.699 (0.157–3.125)	0.637
Non-fatal stroke (%)	1 (0.6)	1 (0.6)	0.931 (0.058–14.883)	0.960
Revascularization (%)	12 (7.1)	26 (14.4)	2.094 (1.056–4.150)	0.028
Cardiac rehospitalization (%)	22 (13.0)	30 (16.6)	1.312 (0.757–2.2740)	0.332
Cardiac death (%)	2 (1.2)	4 (2.2)	1.872 (0.343–10.222)	0.469

Abbreviations: PTX3, pentraxin 3; ΔPTX3, the change in PTX3 from admission to post-pPCI 24-hour; MACCEs, major adverse cardiac cerebral events; MI, myocardial infarction.

Figure 5 Kaplan–Meier curves for MACCEs (A), non-fatal MI (B), non-fatal stroke (C), revascularization (D), cardiac rehospitalization (E) and Cardiac death (F) of the ΔPTX3≥29.22 ng/dl group (green line) versus the ΔPTX3<29.22 ng/dl group (blue line).

Abbreviations: MACCEs, major adverse cardiac cerebral events; MI, myocardial infarction; PTX3, pentraxin 3; PCI, percutaneous coronary intervention; ΔPTX3, the change in PTX3 from admission to post-pPCI 24-hour.