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http://dx.doi.org/10.4070/kcj.2014.44.4.220

Pentraxin 3 Is Highly Specific for Predicting Anatomical Complexity of Coronary Artery Stenosis as Determined by the Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery Score  

Namazi, Mohammad Hasan (Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences)
Saadat, Habibollah (Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences)
Safi, Morteza (Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences)
Vakili, Hossein (Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences)
Alipourparsa, Saeed (Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences)
Bozorgmanesh, Mohammadreza (Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences)
Haybar, Habib (Cardiovascular Research Center, Ahvaz Jundishapur University of Medical Science)
Publication Information
Korean Circulation Journal / v.44, no.4, 2014 , pp. 220-226 More about this Journal
Abstract
Background and Objectives: The aim of this study was to examine the hypothesis that pentraxin 3 (PTX3) can have a diagnostic value for predicting anatomical complexity of coronary artery stenosis as measured by the Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) score. Subjects and Methods: We investigated the association of systemic arterial PTX3 with SYNTAX score among 500 patients with ischemic heart disease assigned to medical treatment (251), percutaneous coronary intervention (PCI) (197), or coronary artery bypass graft (CABG) (52). Results: The clinical judgment of the cardiologists was near-perfectly concordant with the SYNTAX score. Mean {99% confidence intervals (CIs)} SYNTAX scores were 5.8 (5.1-6.6), 18.4 (17.1-19.8), and 33.2 (32.8-33.6) in patients assigned to medical therapy, PCI, and CABG, respectively. The AROC (95% CIs) for discriminating between patients with and without a high SYNTAX score (>23) was 0.920 (0.895-0.946) for systemic arterial levels of PTX3. As the systemic arterial level of PTX3 increased, the SYNTAX scores also increased almost in a curvilinear fashion, with the value corresponding to the SYNTAX score of 23 being $0.29ng{\cdot}dL^{-1}$. This cutpoint achieved a sensitivity of 0.66 (0.57-0.74), a specificity of 0.94 (0.91-0.96), a positive predictive value of 0.79 (0.70-0.87), and a negative predictive value of 0.89 (0.85-0.92). Conclusion: We observed that systemic arterial levels of PTX3 were associated with the SYNTAX score in a curvilinear fashion. The discriminatory power of systemic arterial levels of PTX3 for a high SYNTAX score was excellent. The interesting finding of this study was the near perfect concordance between the decisions made by the cardiologists based on their clinical judgment and the SYNTAX score. The systemic arterial PTX3 level of $0.29ng{\cdot}dL^{-1}$ was highly specific for diagnosing complex coronary artery stenosis.
Keywords
PTX3 protein; Coronary artery disease; Percutaneous coronary intervention; Coronary artery bypass grafting; Angiography;
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