The implication of calcium score and pentraxin-3 in non-invasive identification of significant coronary artery stenosis in chronic stable angina pectoris

Objective: Coronary Artery Disease (CAD) would continue to concern medical society in the foreseeable future. Determining the extent of coronary luminal stenosis is a key factor in management of CAD. Methods presently used are costly and pose certain dangers, ranging from nephrotoxicity to death. Long Pentraxin or Pentraxin-3 (PTX3) has been used to predict survival or atherosclerotic process, but not to identify coronary stenosis. Calcium Score has been used to this end with some success. Methods: Individuals with chronic stable angina, without evidence of Myocardial Infarction (MI), who were categorized as intermediate-risk after completing a treadmill exercise test, according to Duke Protocol, underwent cardiac catheterization. In addition, blood samples were drawn for coronary sinus PTX3, and also PTX3, uric acid, high-sensitivity C-reactive protein (hs-CRP), cholesterol, glucose and High-Density Lipo-protein (HDL) in peripheral circulation. Calcium Scores were calculated using Agatston Score and non-contrast multi-slice CT scan. Participants were divided according to the number of stenotic coronary arteries (patent, one-, two-and three-vessel disease). Results: We found that PTX3 levels in coronary sinus and femoral vein correlated with each other, after log-transforming the values. Also we found that PTX3 levels and Calcium Scores differed among individuals with triple-vessel involvement and individuals without significant stenosis in any of coronary arteries. No significant differences were observed, regarding hs-CRP levels. Conclusion: PTX3 levels in periphery correlate with those in coronary arteries, and this variable can be measured with a less invasive procedure. In addition to Calcium Score, PTX3 levels are different in our four groups. The combined contribution of PTX3 and calcium score may help us identify individuals with significant coronary artery stenosis without needing to perform cardiac catheterization in a select group of patients.