The serum pentraxin-3 is elevated in patients with cardiac syndrome X

Objectives: Cardiac syndrome X (CSX) is a clinical entity that is defined as normal coronary arteries with angina pectoris and objective sins of ischemia. The correlation between CSX and inflammatory markers such as high-sensitivity C-reactive protein (hs-CRP) is well established, however an association with pentraxin-3 (PTX-3) has not been examined. The aim of this study was to investigate the association between PTX-3 and CSX. Study design: A total of 122 patients (58 female, 64 male, mean age 49.6 +/- 5.8 years) with suspected of coronary artery disease (CAD) were included in the study. Those with evidence of ischemia (50 patients with positive treadmill tests, 32 patients with positive myocardial perfusion scintography) underwent coronary angiography (82 patients). Patients with a normal angiogram were considered the CSX group (n=41) and patients with coronary lesions were referred to as the CAD group (n=41). Patients without signs of ischemia served as the control group. Serum PTX-3 and hs-CRP levels were measured in all patients. Results: The CSX group had significantly increased PTX-3 levels relative to the control group (0.46 +/- 0.16 vs. 0.23 +/- 0.09 ng/ml, p<0.001). However there were no differences in levels of PTX-3 and hs-CRP between the CSX and the CAD groups (PTX-3: 0.46 +/- 0.16 vs. 0.51 +/- 0.13 ng/ml, p=0.21; hs-CRP: 1.04 +/- 0.45 vs. 1.16 +/- 0.64 mg/dl, p=0.62). The control group had significantly lower hs-CRP levels (0.73 +/- 0.51 mg/dl) when compared to the both CSX and CAD groups (p=0.03 and p=0.002, respectively). Serum PTX-3 levels were weakly correlated with hs-CRP levels (r=0.30, p=0.001). Conclusion: PTX-3, a novel inflammatory marker, is elevated in patients with CSX, similar to the well known inflammatory marker hs-CRP, and may be a promising biomarker reflecting inflammatory status in these patients.