VALUE OF PLASMA PENTRAXIN 3 (PTX3) LEVELS IN PREDICTING ASYMPTOMATIC PRECLINICAL HYPERTENSIVE-RELATED ATHEROSCLEROTIC VASCULAR DISEASE IN EGYPTIAN PATIENTS WITH PRIMARY HYPERTENSION

Background: Pentraxins are generally considered acute phase proteins. Pentraxin 3 (PTX3), a long pentraxin, has been identified as an inflammatory biomarker, and its blood levels increase rapidly and dramatically in inflammatory conditions. Elevated plasma PTX3 levels were reported in patients with high systolic and diastolic blood pressures, and PTX3 can be an early marker of arteriosclerotic vascular damage. Carotid artery intima-media thickness (cIMT) is a well-established surrogate marker for subclinical atherosclerosis. However, the association between biomarkers of systemic inflammation and atherosclerosis progression in carotid artery is not well established. Aim of Study: Was to evaluate the value of plasma PTX3 level as a predictor for asymptomatic preclinical hypertensive-related atherosclerotic vascular disease. Subjects and Methods: 75 patients with primary hypertension who had no history or manifestations suggesting atherosclerotic vascular disease and 15 healthy subjects (control group) were included. Full history taking and thorough medical examination were done. Patients' weight, height, BMI, and blood pressure were assessed. Laboratory investigations (urine analysis, UACR, CBC, ESR, CRP, liver enzymes, urea, creatinine, blood sugar levels, HbA1c, uric acid, LDL cholesterol, HDL cholesterol, triglyceride, and PTX3 levels), ECG, echocardiography, and carotid ultrasonography (for measuring cIMT) were performed for all patients. Results: The mean age of patients was 54.7±9.3 years (range, 38-73 years). Asymptomatic preclinical atherosclerotic vascular disease, as reflected by cIMT > 0.1cm, was reported in 39 patients (52%). Hypertensive patients with LDL cholesterol ≥ 100mg/dL or with HDL cholesterol < 50mg/dL for males and < 40mg/dL for females had significantly higher plasma PTX3 levels. Higher degrees of UACR and albuminuria were associated with significantly elevated plasma PTX3 levels. Plasma PTX3 levels were significantly higher in hypertensive patients with preclinical atherosclerotic vascular disease, as reflected by cIMT > 0.1cm, compared to those without. Significant positive correlation was noted between plasma PTX3 levels and cIMT in hypertensive patients. Conclusion: Elevated plasma PTX3 levels were correlated with cIMT, a marker for preclinical atherosclerosis, in Egyptian hypertensive patients with asymptomatic preclinical atherosclerotic vascular disease, regardless of hypertension stages.