Elevated levels of systemic pentraxin 3 are associated with thin-cap fibroatheroma in coronary culprit lesions: assessment by optical coherence tomography and intravascular ultrasound

JACC Cardiovasc Interv. 2013 Sep;6(9):945-54. doi: 10.1016/j.jcin.2013.04.024. Epub 2013 Aug 14.

Abstract

Objectives: This study sought to determine whether systemic levels of pentraxin 3 (PTX3), a novel inflammatory marker, are associated with thin-cap fibroatheroma (TCFA).

Background: Biomarkers predicting the presence of TCFA in vivo have not been established.

Methods: We evaluated 75 patients (stable angina pectoris, n = 47; acute coronary syndrome, n = 28) with de novo culprit lesions who were examined by optical coherence tomography and intravascular ultrasound. We defined TCFA as lipid-rich plaque with a fibrous cap <65 μm thick. Systemic levels of PTX3 were compared between patients with and without TCFA.

Results: Thirty-eight and 37 patients with and without TCFA, respectively, were identified. Levels of PTX3 were significantly higher in patients with than in those without TCFA (p < 0.001) and correlated inversely with fibrous cap thickness (r = -0.71, p = 0.001) and positively with the remodeling index (r = 0.25, p = 0.037). Multivariate logistic regression analysis showed that a higher PTX3 level was the most powerful predictor of TCFA (odds ratio: 3.26, 95% confidence interval: 1.75 to 6.05, p < 0.001). Receiver-operating characteristic curve analysis showed that >3.24 ng/ml of PTX3 could predict TCFA with 84% sensitivity and 86% specificity.

Conclusions: Higher levels of systemic PTX3 are associated with TCFA. Systemic PTX3 levels comprise a useful inflammatory marker that reflects coronary plaque vulnerability.

Keywords: ACS; AMI; C-reactive protein; CRP; CSA; EEM; IVUS; OCT; P+M; PTX3; SAP; TCFA; UAP; acute coronary syndromes; acute myocardial infarction; cross-sectional area; external elastic membrane; high-sensitivity C-reaction protein; hs-CRP; intravascular ultrasound; optical coherence tomography; pentraxin 3; plaque plus media; stable angina pectoris; thin-cap fibroatheroma; unstable angina pectoris; vulnerable plaque.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biomarkers / blood
  • C-Reactive Protein / analysis*
  • Case-Control Studies
  • Chi-Square Distribution
  • Coronary Angiography
  • Coronary Artery Disease / blood
  • Coronary Artery Disease / diagnosis*
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / pathology
  • Coronary Vessels / diagnostic imaging*
  • Coronary Vessels / pathology*
  • Female
  • Fibrosis
  • Humans
  • Inflammation Mediators / blood*
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Plaque, Atherosclerotic*
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Serum Amyloid P-Component / analysis*
  • Tomography, Optical Coherence*
  • Ultrasonography, Interventional*
  • Up-Regulation

Substances

  • Biomarkers
  • Inflammation Mediators
  • Serum Amyloid P-Component
  • PTX3 protein
  • C-Reactive Protein