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Serum Pentraxin 3 Levels Are Associated With the Complexity and Severity of Coronary Artery Disease in Patients With Stable Angina Pectoris
  1. Mehmet Fatih Karakas, MD*,
  2. Eyup Buyukkaya, MD*,
  3. Mustafa Kurt, MD*,
  4. Sedat Motor, MD,
  5. Adnan Burak Akcay, MD*,
  6. Şule Buyukkaya, MD,
  7. Esra Karakas, MD§,
  8. Perihan Bilen, MD*,
  9. Nihat Sen, MD*
  1. From the Departments of *Cardiology and, †Clinical Biochemistry, Mustafa Kemal University, Tayfur Ata Sokmen Medical School; ‡Department of Cardiology, Antakya State Hospital; and §Department of Endocrinology andMetabolism, Mustafa Kemal University, Tayfur Ata Sokmen Medical School, Hatay, Turkey.
  1. Received June 10, 2012, and in revised form September 2, 2012.
  2. Accepted for publication October 17, 2012.
  3. Reprints: Mehmet Fatih Karakas, MD, Department of Cardiology, Mustafa Kemal University, Tayfur Ata Sokmen Medical School, Serinyol, Antakya 31005, Turkey. E-mail: mfkarakas{at}
  4. This study has no funding sources.
  5. The authors have no conflicts of interest to declare.


Background Atherosclerosis is a complex inflammatory process in which inflammatory markers are involved. Although pentraxin 3 (PTX-3), a newly identified inflammatory marker, was associated with adverse outcomes in stable angina pectoris, no association between PTX-3 and the complexity of coronary artery disease (CAD) has been reported. Thus, the aim of the present study was to assess the association between the level of PTX-3 and the complexity and severity of CAD assessed with SYNTAX and Gensini scores in patients with stable angina pectoris.

Methods The study population consisted of 2 groups: 161 patients with anginal symptoms and evidence of ischemia who underwent coronary angiography and 50 age- and sex- matched control subjects without evidence of ischemia were included. Patients were grouped into 3 groups according to the complexity and severity of coronary lesions assessed by the SYNTAX score (30 patients with a SYNTAX score of 0 were excluded). Serum PTX-3 and high-sensitivity C-reactive protein (hs-CRP) levels were measured.

Results The PTX-3 levels demonstrated an increase from low to high SYNTAX groups (r = 0.72, P < 0.001). Whereas the low SYNTAX group had statistically significantly higher PTX-3 levels when compared with the control group (0.50 ± 0.01 vs 0.24 ± 0.01 ng/mL, P < 0.001), the hs-CRP levels were not different (0.81 ± 0.42 vs 0.86 ± 0.53 mg/dL, P = 0.96). However, the intermediate SYNTAX group had higher hs-CRP levels compared with the low SYNTAX group (1.3 ± 0.66 vs 0.86 ± 0.53 mg/dL, P = 0.002). Serum PTX-3 levels and hs-CRP levels were correlated with the SYNTAX scores and Gensini scores (for SYNTAX: r = 0.87 [P < 0.001] and r = 0.36 [P = 0.01]; for Gensini: r = 0.75 [P < 0.001] and r = 0.27 [P = 0.002], respectively), and according to the results of univariate and multivariate analyses, for “intermediate and high” SYNTAX scores, age, diabetes mellitus, low-density lipoprotein cholesterol, hs-CRP, and PTX-3 were found to be independent predictors, whereas for the presence of “high” SYNTAX score only PTX-3 was found to be an independent predictor. The receiver operating characteristic curve analysis further revealed that the PTX-3 level was a strong indicator of high SYNTAX score with an area under the curve of 0.91 (95% confidence interval, 0.86–0.96).

Conclusions Pentraxin 3, a novel inflammatory marker, was more tightly associated with the complexity and severity of CAD than hs-CRP and was found to be an independent predictor for high SYNTAX score.

Key Words
  • pentraxin 3
  • coronary artery disease
  • SYNTAX score
  • hs-CRP
  • inflammation

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