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Published on: January 28, 2020
Prognostic value of myeloperoxidase concentration in patients with ST-segment elevation myocardial infarction treated
Michal Kacprzak1, Marzenna Zielinska1
1Intensive Cardiac Therapy Clinic, Medical University of Lodz, Poland.
Abstract:
Inflammation plays an important role on every stage of atherosclerosis. Myeloperoxidase (MPO), a leukocyte-derived enzyme that participates in the innate immunity, probably is involved in many stages of atherothrombosis. According to the recent studies, MPO is related with unfavorable outcome in patients with chest pain and acute coronary syndromes. Its role in prediction of outcomes after ST-segment elevation myocardial infarction (STEMI) remains unclear. The aim of the study was to assess if elevated MPO level is a predictor of long-term adverse cardiac events in patients with STEMI treated with primary percutaneous coronary intervention (pPCI).
Material And Methods:
We evaluated data of 127 patients with STEMI. Plasma levels of MPO collected on admission and the 3rd-4th day of hospitalization were measured by ELISA method. C-reactive protein (CRP) and N-terminal prohormone of B-type natriuretic peptide (NT-proBNP) were also determined. All patients were followed-up prospectively for the occurrence of major adverse cardiovascular events (MACE) defined as unscheduled coronary revascularization procedure, stroke, reinfarction or all-cause death.
Results:
After 14months of follow-up 20% of patients developed MACE. Elevated MPO levels collected on the 3rd-4th day of STEMI were the predictor of death, reinfarction, the need for coronary revascularization and all adverse events taken together. In multivariate analysis, MPO and CRP levels assessed on the 3rd-4th day of hospitalization revealed to be significant predictors of MACE. MPO demonstrated to be significantly better predictor of MACE than NT-proBNP level.
Conclusions:
Myeloperoxidase is a prognostic marker in patients with STEMI treated with pPCI.
Insights
Elevated myeloperoxidase (MPO) levels on days 3-4 after ST-segment elevation myocardial infarction (STEMI) predict adverse cardiac events. MPO is a significant prognostic marker in STEMI patients undergoing primary percutaneous coronary intervention (pPCI).
Area of Science:
- Cardiology
- Immunology
- Biochemistry
Background:
- Inflammation is central to atherosclerosis development and progression.
- Myeloperoxidase (MPO), an enzyme from leukocytes, is implicated in innate immunity and atherothrombosis.
- Previous studies link MPO to poor outcomes in acute coronary syndromes, but its predictive value in ST-segment elevation myocardial infarction (STEMI) is unclear.
Purpose of the Study:
- To investigate if elevated MPO levels predict long-term adverse cardiac events in STEMI patients.
- To assess the prognostic value of MPO in patients treated with primary percutaneous coronary intervention (pPCI).
Main Methods:
- 127 STEMI patients were analyzed.
- Plasma MPO levels were measured on admission and days 3-4 post-STEMI using ELISA.
- Major adverse cardiovascular events (MACE) were prospectively followed for 14 months.
Main Results:
- 20% of patients experienced MACE within 14 months.
- Elevated MPO levels on days 3-4 post-STEMI predicted death, reinfarction, and revascularization needs.
- MPO and C-reactive protein (CRP) levels on days 3-4 were significant predictors of MACE in multivariate analysis.
- MPO was a superior predictor of MACE compared to NT-proBNP.
Conclusions:
- Myeloperoxidase serves as a valuable prognostic marker.
- MPO levels measured during hospitalization can predict long-term outcomes in STEMI patients treated with pPCI.
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