Pentraxin-3 in chronic heart failure: the CORONA and GISSI-HF trials

Eur J Heart Fail. 2012 Sep;14(9):992-9. doi: 10.1093/eurjhf/hfs092. Epub 2012 Jun 27.


Aims: Pentraxin-3 (PTX3) is a component of the humoral arm of innate immunity which can regulate inflammatory processes. Since the role of inflammation in the progression of chronic heart failure (HF) is debated, we investigated the prognostic value of PTX3 and the effect of a statin in two large populations of patients with HF.

Methods and results: Plasma levels of PTX3 were measured at randomization and after 3 months in 1457 patients enrolled in the Controlled Rosuvastatin Multinational Trial in HF (CORONA) and 1233 patients enrolled in the GISSI-Heart Failure trial (GISSI-HF). The relationships between baseline PTX3 levels or their changes over time and mortality were evaluated with multivariable Cox proportional hazard models including clinical factors, high sensitivity C-reactive protein (hsCRP), and N-terminal pro brain natriuretic peptide (NT-proBNP). PTX3 concentration [median (Q1-Q3) = 5.34 (3.55-7.64) ng/mL, n = 2690] was higher in females, in older patients, and those with lower body mass index. Baseline elevated PTX3 was associated with a higher risk of all-cause mortality [759 events, hazard ratio (HR) for 1 SD increase 1.20, 95% confidence interval (CI) 1.12-1.30, P < 0.0001], cardiovascular mortality (587 events, HR 1.27, 95% CI 1.17-1.38, P < 0.0001), or hospitalization for worsening HF (720 events, HR 1.21, 95% CI 1.12-1.30, P < 0.0001), and marginally improved discrimination. Three-month changes in PTX3 were associated with fatal events after adjustment for hsCRP or NT-proBNP. Rosuvastatin lowered hsCRP levels but significantly raised PTX3.

Conclusion: In two independent clinical trials that enrolled patients with chronic HF, PTX3 was consistently associated with outcomes. The opposite effects of a statin on hsCRP and PTX3 call for further investigation.

Trial registration: NCT00336336 (GISSI-HF), NCT00206310 (CORONA).

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • C-Reactive Protein / drug effects
  • C-Reactive Protein / metabolism*
  • Chronic Disease
  • Double-Blind Method
  • Female
  • Fluorobenzenes / therapeutic use*
  • Heart Failure / blood*
  • Heart Failure / drug therapy*
  • Heart Failure / mortality
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Inflammation / metabolism
  • Male
  • Middle Aged
  • Prognosis
  • Proportional Hazards Models
  • Pyrimidines / therapeutic use*
  • Risk Assessment
  • Rosuvastatin Calcium
  • Serum Amyloid P-Component / drug effects
  • Serum Amyloid P-Component / metabolism*
  • Sulfonamides / therapeutic use*


  • Fluorobenzenes
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Pyrimidines
  • Serum Amyloid P-Component
  • Sulfonamides
  • PTX3 protein
  • Rosuvastatin Calcium
  • C-Reactive Protein

Associated data