High Plasma Myeloperoxidase Is Associated with Plaque Erosion in Patients with ST-Segment Elevation Myocardial...

Area of Science:

• Cardiovascular Medicine
• Biomarkers
• Interventional Cardiology

Background:

• ST-segment elevation myocardial infarction (STEMI) is a critical cardiovascular event.
• Plaque rupture and plaque erosion are distinct pathological mechanisms underlying STEMI.
• Identifying factors associated with plaque erosion is crucial for risk stratification and treatment.

Purpose of the Study:

• To investigate the association between plasma myeloperoxidase (MPO) levels and plaque erosion in STEMI patients.
• To determine if MPO can serve as a biomarker to differentiate plaque erosion from plaque rupture.
• To explore the independent association of MPO with plaque erosion in STEMI.

Main Methods:

• Prospective enrollment of 252 STEMI patients undergoing optical coherence tomography (OCT).
• Culprit lesion evaluation using OCT to classify plaque rupture or erosion.
• Plasma MPO levels measured via enzyme-linked immunoassay.
• Statistical analysis including multivariable logistic regression and ROC curve analysis.

Main Results:

• Plasma MPO levels were significantly higher in patients with plaque erosion compared to plaque rupture (96.3 ng/mL vs. 41.7 ng/mL, p < 0.001).
• Multivariable analysis revealed plasma MPO was independently associated with plaque erosion (OR, 3.25; 95% CI, 1.37-7.76; p = 0.008).
• The area under the ROC curve for MPO was 0.75 in discriminating between plaque erosion and rupture.

Conclusions:

• Plasma MPO is significantly elevated in STEMI patients with plaque erosion.
• MPO demonstrates independent association and discriminatory potential for plaque erosion in STEMI.
• Elevated plasma MPO may serve as a valuable biomarker for identifying plaque erosion in STEMI.