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Myeloperoxidase, but not C-reactive protein, predicts cardiovascular risk in peripheral arterial disease

Gregorio Brevetti1, Vittorio Schiano, Eugenio Laurenzano

  • 1Department of Clinical Medicine and Cardiovascular and Immunological Sciences, University of Naples Federico II, Via Pansini 5, Naples, Italy. brevetti@unina.it

European Heart Journal
|December 25, 2007
PubMed
Abstract

Insights

Myeloperoxidase (MPOx) levels, not C-reactive protein, predict major cardiovascular events in peripheral arterial disease (PAD) patients. MPOx improves risk prediction when combined with the ankle-brachial index (ABI).

Area of Science:

  • Cardiovascular Medicine
  • Biomarkers and Inflammation

Background:

  • The prognostic significance of inflammation in peripheral arterial disease (PAD) requires further clarification.
  • Investigating novel inflammatory markers alongside established ones is crucial for predicting cardiovascular events in PAD patients.

Purpose of the Study:

  • To evaluate the predictive value of myeloperoxidase (MPOx) and C-reactive protein (CRP) for myocardial infarction and stroke in PAD patients.
  • To determine if MPOx and CRP improve risk stratification beyond the ankle-brachial index (ABI).

Main Methods:

  • A cohort of 156 PAD patients was followed for cardiovascular events.
  • Receiver operating characteristic (ROC) curve analysis and bootstrap methods identified optimal cut-off levels for MPOx, CRP, and ABI.
  • Prognostic associations were assessed using hazard ratios (HR) and confidence intervals (CI).

Main Results:

  • Myeloperoxidase (MPOx) above 183.7 pM was independently associated with a higher risk of adverse cardiovascular outcomes (HR = 6.80, P = 0.031).
  • C-reactive protein (CRP) did not demonstrate prognostic value in this cohort (HR = 0.88, P = 0.514).
  • Combining MPOx measurements with ABI enhanced the ability to identify patients at risk for myocardial infarction and stroke.

Conclusions:

  • Myeloperoxidase (MPOx) is a significant predictor of major cardiovascular events in PAD patients.
  • Unlike CRP, MPOx adds incremental prognostic value to the ankle-brachial index (ABI) for risk stratification in PAD.

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