Association of Plasma Pentraxin-3 Levels on Admission with In-hospital Mortality in Patients with Acute Type A Aortic Dissection

Background: Acute aortic dissection is a life-threatening cardiovascular emergency. Pentraxin-3 (PTX3) is proposed as a prognostic marker and found to be related to worse clinical outcomes in various cardiovascular diseases. This study sought to investigate the association of circulating PTX3 levels...

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Main Authors: Qin Zhou, Xiang-Ping Chai, Zhen-Fei Fang, Xin-Qun Hu, Liang Tang
Format: Article
Language:English
Published: Wolters Kluwer 2016-01-01
Series:Chinese Medical Journal
Subjects:
Online Access:http://www.cmj.org/article.asp?issn=0366-6999;year=2016;volume=129;issue=21;spage=2589;epage=2595;aulast=Zhou
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author Qin Zhou
Xiang-Ping Chai
Zhen-Fei Fang
Xin-Qun Hu
Liang Tang
author_facet Qin Zhou
Xiang-Ping Chai
Zhen-Fei Fang
Xin-Qun Hu
Liang Tang
author_sort Qin Zhou
collection DOAJ
description Background: Acute aortic dissection is a life-threatening cardiovascular emergency. Pentraxin-3 (PTX3) is proposed as a prognostic marker and found to be related to worse clinical outcomes in various cardiovascular diseases. This study sought to investigate the association of circulating PTX3 levels with in-hospital mortality in patients with acute Type A aortic dissection (TAAD). Methods: A total of 98 patients with TAAD between January 2012 and December 2015 were enrolled in this study. Plasma concentrations of PTX3 were measured upon admission using a high-sensitivity enzyme-linked immunosorbent assay system. Patients were divided into two groups as patients died during hospitalization (Group 1) and those who survived (Group 2). The clinical, laboratory variables, and imaging findings were analyzed between the two groups, and predictors for in-hospital mortality were evaluated using multivariate analysis. Results: During the hospital stay, 32 (33%) patients died and 66 (67%) survived. The patients who died during hospitalization had significantly higher PTX3 levels on admission compared to those who survived. Pearson's correlation analysis demonstrated that PTX3 correlated positively with high-sensitivity C-reactive protein (hsCRP), maximum white blood cell count, and aortic diameter. Multivariate logistic regression analysis demonstrated that PTX3 levels, coronary involvement, cardiac tamponade, and a conservative treatment strategy are significant independent predictors of in-hospital mortality in patients with TAAD. The receiver operating characteristic curve analysis further illustrated that PTX3 levels on admission were strong predictors of mortality with an area under the curve of 0.89. A PTX3 level ≥5.46 ng/ml showed a sensitivity of 88% and a specificity of 79%, and an hsCRP concentration ≥9.5 mg/L had a sensitivity of 80% and a specificity of 69% for predicting in-hospital mortality. Conclusion: High PTX3 levels on admission are independently associated with the in-hospital mortality in patients with TAAD.
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spelling doaj.art-3308c986a21d483d87aa1b165c5457392022-12-22T01:08:58ZengWolters KluwerChinese Medical Journal0366-69992016-01-01129212589259510.4103/0366-6999.192785Association of Plasma Pentraxin-3 Levels on Admission with In-hospital Mortality in Patients with Acute Type A Aortic DissectionQin ZhouXiang-Ping ChaiZhen-Fei FangXin-Qun HuLiang TangBackground: Acute aortic dissection is a life-threatening cardiovascular emergency. Pentraxin-3 (PTX3) is proposed as a prognostic marker and found to be related to worse clinical outcomes in various cardiovascular diseases. This study sought to investigate the association of circulating PTX3 levels with in-hospital mortality in patients with acute Type A aortic dissection (TAAD). Methods: A total of 98 patients with TAAD between January 2012 and December 2015 were enrolled in this study. Plasma concentrations of PTX3 were measured upon admission using a high-sensitivity enzyme-linked immunosorbent assay system. Patients were divided into two groups as patients died during hospitalization (Group 1) and those who survived (Group 2). The clinical, laboratory variables, and imaging findings were analyzed between the two groups, and predictors for in-hospital mortality were evaluated using multivariate analysis. Results: During the hospital stay, 32 (33%) patients died and 66 (67%) survived. The patients who died during hospitalization had significantly higher PTX3 levels on admission compared to those who survived. Pearson's correlation analysis demonstrated that PTX3 correlated positively with high-sensitivity C-reactive protein (hsCRP), maximum white blood cell count, and aortic diameter. Multivariate logistic regression analysis demonstrated that PTX3 levels, coronary involvement, cardiac tamponade, and a conservative treatment strategy are significant independent predictors of in-hospital mortality in patients with TAAD. The receiver operating characteristic curve analysis further illustrated that PTX3 levels on admission were strong predictors of mortality with an area under the curve of 0.89. A PTX3 level ≥5.46 ng/ml showed a sensitivity of 88% and a specificity of 79%, and an hsCRP concentration ≥9.5 mg/L had a sensitivity of 80% and a specificity of 69% for predicting in-hospital mortality. Conclusion: High PTX3 levels on admission are independently associated with the in-hospital mortality in patients with TAAD.http://www.cmj.org/article.asp?issn=0366-6999;year=2016;volume=129;issue=21;spage=2589;epage=2595;aulast=ZhouMortality; Pentraxin-3; Aortic Dissection
spellingShingle Qin Zhou
Xiang-Ping Chai
Zhen-Fei Fang
Xin-Qun Hu
Liang Tang
Association of Plasma Pentraxin-3 Levels on Admission with In-hospital Mortality in Patients with Acute Type A Aortic Dissection
Chinese Medical Journal
Mortality; Pentraxin-3; Aortic Dissection
title Association of Plasma Pentraxin-3 Levels on Admission with In-hospital Mortality in Patients with Acute Type A Aortic Dissection
title_full Association of Plasma Pentraxin-3 Levels on Admission with In-hospital Mortality in Patients with Acute Type A Aortic Dissection
title_fullStr Association of Plasma Pentraxin-3 Levels on Admission with In-hospital Mortality in Patients with Acute Type A Aortic Dissection
title_full_unstemmed Association of Plasma Pentraxin-3 Levels on Admission with In-hospital Mortality in Patients with Acute Type A Aortic Dissection
title_short Association of Plasma Pentraxin-3 Levels on Admission with In-hospital Mortality in Patients with Acute Type A Aortic Dissection
title_sort association of plasma pentraxin 3 levels on admission with in hospital mortality in patients with acute type a aortic dissection
topic Mortality; Pentraxin-3; Aortic Dissection
url http://www.cmj.org/article.asp?issn=0366-6999;year=2016;volume=129;issue=21;spage=2589;epage=2595;aulast=Zhou
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AT xiangpingchai associationofplasmapentraxin3levelsonadmissionwithinhospitalmortalityinpatientswithacutetypeaaorticdissection
AT zhenfeifang associationofplasmapentraxin3levelsonadmissionwithinhospitalmortalityinpatientswithacutetypeaaorticdissection
AT xinqunhu associationofplasmapentraxin3levelsonadmissionwithinhospitalmortalityinpatientswithacutetypeaaorticdissection
AT liangtang associationofplasmapentraxin3levelsonadmissionwithinhospitalmortalityinpatientswithacutetypeaaorticdissection