Evaluation of Diagnostic Utility of Pentraxin-3 in Acute Coronary Syndrome Patients: A Pilot Study from Tertiary Care Hospital in South India

Abstract

Background: Pentraxin 3 (PTX3), a member of C-reactive protein-like inflammatory protein group, is abundantly expressed in atherosclerotic plaques, as well as in cardiac myocytes. Increased serum PTX3 level has been observed in patients with the acute coronary syndrome (ACS). The diagnostic role of PTX3 in all three types of ACS in the Indian population is limited. This study aimed to investigate whether serum PTX3 can be used as a potential biomarker in the early detection of ACS. Materials and Methods: This is a cross-sectional case-control study comprising of 47 cases and 33 controls. Cases were divided into three groups, out of which 12 patients were of non-ST-segment elevation myocardial infarction (NSTEMI), 23 patients were of ST-segment elevation myocardial infarction (STEMI), and 12 patients were of unstable angina. Patients were recruited within 7 h of post event who are clinically diagnosed as ACS. Lipid parameters were measured on the Roche Cobas c511 analyzer and PTX3 levels were measured by ELISA kit. Results: Serum PTX-3 levels were significantly higher in all three groups of ACS when compared to controls (P < 0.0001). At a cutoff of 4 ng/ml, serum pentraxin-3 showed 97.87% sensitivity and 84.85% specificity in diagnosing ACS cases with a positive predictive value of 90.2% and negative predictive value of 96.6%, and the area under the curve was 0.978. At a cut-off of 3.56 and 6.09 ng/ml, serum PTX-3 has 100% sensitivity and 78.79% specificity and 91.67% sensitivity and 100% specificity in diagnosing NSTEMI and STEMI, respectively. Conclusions: This study demonstrates Pentraxin-3 levels in ACS cases were significantly high and showed as a valuable biomarker for early detection of ACS, particularly within 7 h of postevent. Assessment of pentraxin-3 and Troponin-T together may further improve the early detection of ACS patients.