55695
document
Pentraxin-3 in chronic heart failure : the CORONA and GISSI-HF trials . AIMS Pentraxin-3 ( PTX3 ) is a component of the humoral arm of innate immunity which can regulate inflammatory processes . Since the role of inflammation in the progression of chronic heart failure ( HF ) is debated , we investigated the prognostic value of PTX3 and the effect of a statin in two large populations of patients with HF . METHODS AND RESULTS Plasma levels of PTX3 were measured at randomization and after 3 months in 1457 patients enrolled in the Controlled Rosuvastatin Multinational Trial in HF ( CORONA ) and 1233 patients enrolled in the GISSI-Heart Failure trial ( GISSI-HF ) . The relationships between baseline PTX3 levels or their changes over time and mortality were evaluated with multivariable Cox proportional hazard models including clinical factors , high sensitivity C-reactive protein ( hsCRP ) , and N-terminal pro brain natriuretic peptide ( NT-proBNP ) . PTX3 concentration [ median ( Q1-Q3 ) = 5.34 ( 3.55-7.64 ) ng/mL , n = 2690 ] was higher in females , in older patients , and those with lower body mass index . Baseline elevated PTX3 was associated with a higher risk of all-cause mortality [ 759 events , hazard ratio ( HR ) for 1 SD increase 1.20 , 95 % confidence interval ( CI ) 1.12-1.30 , P < 0.0001 ] , cardiovascular mortality ( 587 events , HR 1.27 , 95 % CI 1.17-1.38 , P < 0.0001 ) , or hospitalization for worsening HF ( 720 events , HR 1.21 , 95 % CI 1.12-1.30 , P < 0.0001 ) , and marginally improved discrimination . Three-month changes in PTX3 were associated with fatal events after adjustment for hsCRP or NT-proBNP . Rosuvastatin lowered hsCRP levels but significantly raised PTX3 . CONCLUSION In two independent clinical trials that enrolled patients with chronic HF , PTX3 was consistently associated with outcomes . The opposite effects of a statin on hsCRP and PTX3 call for further investigation . TRIAL REGISTRATION NCT00336336 ( GISSI-HF ) , NCT00206310 ( CORONA ) .
55696
Intervention_Pharmacological
Pentraxin-3
55697
Intervention_Pharmacological
Pentraxin-3 ( PTX3 )
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Intervention_Pharmacological
PTX3
55699
Intervention_Pharmacological
statin
55700
Intervention_Pharmacological
PTX3
55701
Intervention_Pharmacological
baseline PTX3 levels
55702
Intervention_Pharmacological
PTX3
55703
Intervention_Pharmacological
Baseline elevated PTX3
55704
Intervention_Pharmacological
PTX3
55705
Intervention_Pharmacological
PTX3
55706
Intervention_Pharmacological
statin
55707
Intervention_Pharmacological
PTX3
55708
Outcome_Physical
PTX3 concentration
55709
Outcome_Mortality
risk of all-cause mortality
55710
Outcome_Mortality
cardiovascular mortality
55711
Outcome_Physical
hospitalization for worsening HF
55712
Outcome_Mortality
fatal events
55713
Outcome_Physical
hsCRP levels
55714
Outcome_Physical
PTX3 .
55715
Participant_Condition
chronic heart failure :
55716
Participant_Sample-size
1457 patients
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Participant_Condition
Controlled Rosuvastatin Multinational Trial in HF ( CORONA
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Participant_Sample-size
1233 patients
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Participant_Condition
patients with chronic HF