PTX3 expression in the plasma of elderly ACI patients and its relationship with severity and prognosis of the disease.

OBJECTIVE: This study aims to investigate the expression of pentraxin3 (PTX3) in elderly patients with acute cerebral infarction (ACI) and to analyze the relationship of PTX3 with the severity and prognosis of ACI.

PATIENTS AND METHODS: Between June 2014 and August 2015, 96 elderly patients with first-onset of ACI admitted to our institution were enrolled in the present study. Also, 70 healthy elderly subjects were included as controls in this study. Levels of PTX3, C-reactive protein (CRP), tumor necrosis factor (TNF)-α, homocysteine (Hcy), fibrinogen (FIB), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were determined in all patients both pre-therapeutically and 30 days post-therapeutically. Moreover, the severity of ACI was evaluated using the National Institute of Health stroke scale (NIHSS), and the prognosis was evaluated using the Modified Rankin Scale (mRS). The differences in the levels of above parameters were compared between groups, and the relationship between PTX3 and above biochemical parameters as well as the scores were investigated.

RESULTS: PTX3 levels in the plasma of ACI patients were significantly higher than those of healthy controls (p < 0.05). Compared to low score group, mRS and levels of all parameters except Hcy and HDL-C were significantly increased in the patients of the high score group. In addition, plasma levels of HDL-C in the patients of the high score group were significantly lower than those in the low score group (p < 0.05). Biochemical parameters, NIHSS scores and mRS scores were significantly higher in the patients of the high concentration group than the low concentration group (p < 0.05), while no significant differences were observed in the plasma HDL-C levels between these two groups (p > 0.05). NIHSS scores and levels of all the biochemical parameters except HDL-C were significantly lower in the patients of the good prognosis group than in the patients of the poor prognosis group. HDL-C levels were significantly higher in the good prognosis group than in the poor prognosis group (p < 0.05). PTX3 levels were positively correlated with levels of CRP, TNF-α, Hcy, TC, TG and LDL-C as well as NIHSS score and mRS score, respectively, (r = 0.814, 0.682, 0.704, 0.726, 0.699, 0.734, 0.746, 0.753, p = 0.008, 0.043, 0.034, 0.027, 0.036, 0.024, 0.021, 0.019). However, no significant correlations were observed between FIB levels and HDL-C levels (r = 0.326, 0.626, p = 0.392, 0.071).

CONCLUSIONS: Plasma levels of PTX3 are significantly elevated in elderly ACI patients, and the levels increase along with the exacerbation of the disease and deterioration in the prognosis. Also, PTX3 levels are positively correlated with levels of inflammatory markers as well as lipids. Therefore, PTX3 can be used as a biomarker for predicting and evaluating clinical conditions of ACI in elderly patients.