Pentraxin-3 level at admission is a strong predictor of short-term mortality in a community-based hospital setting

• Autores: S. Bastrup-Birk, L. Munthe-Fog, M.O. Skjoedt, Jane Y. C. Ma, O.H. Nielsen, Lars Kober, O.W. Nielsen, A. K. Iversen, P. Garred
• Localización: Journal of Internal Medicine, ISSN-e 1365-2796, Vol. 277, Nº. 5, 2015, págs. 562-572
• Idioma: inglés
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• Resumen

  • Background The pattern recognition molecule pentraxin-3 (PTX3) is a novel potential marker of prognosis, as elevated levels are associated with both disease severity and mortality in patients with a wide range of conditions. However, the usefulness of PTX3 as a prognostic biomarker in a general hospital setting is unknown.

    Patients and methods The study cohort consisted of 1326 unselected, consecutive patients (age >40 years) admitted to a community hospital in Copenhagen, Denmark. Patients were followed until death or for a median of 11.5 years after admission. The main outcome measure was all-cause mortality. Serum samples collected from patients at admission and from 192 healthy control subjects were quantified for PTX3 level by enzyme-linked immunosorbent assay.

    Results PTX3 was elevated in patients (median 3.7 ng mL−1, range 0.5–209.8) compared with healthy nonhospitalized subjects (median 3.5 ng mL−1, range 0.0–8.3; P = 0.0003). Elevated PTX3 levels, defined as above the 95th percentile of the concentration in healthy subjects, were associated with increased overall mortality during the study (P < 0.0001). This increase in mortality was greatest in the short term, with an unadjusted hazard ratio (HR) of 6.4 [95% confidence interval (CI) 3.8–11.0] at 28 days after admission, compared to 1.7 (95% CI 1.4–2.0) at the end of follow-up. These results were still significant after adjustment for age, gender and glomerular filtration rate: adjusted HR of 5.0 (95% CI 2.9–8.8) and 1.4 (95% CI 1.2–1.8), respectively.

    Conclusion These results suggest that PTX3 could be a widely applicable marker of short-term mortality in hospitalized patients and may be useful in the initial risk stratification.