The Role of Pentraxin 3 in the Assessment of Cardiovascular Risk and Disease Activity in Patients with Rheumatoid Arthritis and Spondyloarthritis

Background: Pentraxin 3 (PTX3) is suggested to be both a marker of inflammation and cardiovascular (CV) risk. Aim: The aim of this study was to identify and compare the role of PTX3 in assessment of disease activity and CV risk, in patients with chronic inflammatory diseases, rheumatoid arthritis (RA), and spondyloarthritis (SpA). Methods: The study group consisted of 235 patients (109 RA, and 126 SpA). The following parameters were assessed: disease activity, traditional CV risk factors, carotid intima media thickness (cIMT), PTX3 plasma concentration. Results: The median (IQR) PTX3 concentration was higher in RA than SpA patients [3.44 (2.56-4.79) vs 2.51 (1.72-3.62) ng/mL, p<0.001]. The mean (SD) cIMT value was higher in RA than SpA patients [0.85 (+/- 0.21) vs 0.75 (+/- 0.27) mm, p=0.02]. Atherosclerotic plaques were observed in similar number of patients with RA (31, 28.4%) and SpA (34, 27%) (NS). The PTX3 level was significantly higher in RA patients with moderate/high vs low disease activity, and in patients with presence vs no atherosclerotic plagues. In patients with RA correlations were found between PTX3 and disease activity parameters: C-reactive protein, erythrocyte sedimentation rate, tender joint count, disease activity score in 28 joints, white blood cell count (WBC). In multiple linear regression analysis, significantly positive association was confirmed for PTX3 and WBC. No significant relationships were found in patients with SpA. Conclusion: The results of this study point to the dual role of PTX3 in patients with RA, as a biomarker of disease activity, and as a marker of CV complications risk.