Potential role of plasma myeloperoxidase level in predicting long-term outcome of acute myocardial infarction

• Published in: Texas Heart Institute journal Vol. 39; no. 4; pp. 500 - 506
• Main Authors: Kaya, Mehmet Gungor, Yalcin, Ridvan, Okyay, Kaan, Poyraz, Fatih, Bayraktar, Nilufer, Pasaoglu, Hatice, Boyaci, Bulent, Cengel, Atiye
• Format: Journal Article
• Language: English
• Published: United States Texas Heart Institute 01.01.2012
• Subjects: Adult; Aged; Aged, 80 and over; Angina Pectoris - blood; Angina Pectoris - enzymology; Angina Pectoris - epidemiology; Biomarkers - blood; Case-Control Studies; Chi-Square Distribution; Clinical Investigation; Female; Heart Failure - blood; Heart Failure - enzymology; Heart Failure - epidemiology; Humans; Incidence; Kaplan-Meier Estimate; Male; Middle Aged; Multivariate Analysis; Myocardial Infarction - blood; Myocardial Infarction - enzymology; Myocardial Infarction - mortality; Myocardial Infarction - therapy; Myocardial Revascularization; Odds Ratio; Patient Readmission; Peroxidase - blood; Prognosis; Proportional Hazards Models; Prospective Studies; Recurrence; Risk Assessment; Risk Factors; Time Factors; Turkey - epidemiology; Up-Regulation; Young Adult; Turkey; major adverse cardiac event; troponin T; C-reactive protein; myocardial infarction, acute/blood/enzymology; peroxidase/blood; survival analysis; creatine kinase, MB form; Biological markers/blood; prospective studies; long-term outcome; coronary artery disease/blood/enzymology
• ISSN: 0730-2347

We investigated the prognostic importance of plasma myeloperoxidase levels in patients with ST-elevation myocardial infarction (STEMI) at long-term follow-up, and we analyzed the correlations between plasma myeloperoxidase levels and other biochemical values. We evaluated 73 consecutive patients (56 men; mean age, 56 ± 11 yr) diagnosed with acute STEMI and 46 age- and sex-matched healthy control participants. Patients were divided into 2 groups according to the median myeloperoxidase level (Group 1: plasma myeloperoxidase ≤ 68 ng/mL; and Group 2: plasma myeloperoxidase > 68 ng/mL). Patients were monitored for the occurrence of major adverse cardiovascular events (MACE), which were defined as cardiac death; reinfarction; new hospital admission for angina; heart failure; and revascularization procedures. The mean follow-up period was 25 ± 16 months. Plasma myeloperoxidase levels were higher in STEMI patients than in control participants (82 ± 34 vs 20 ± 12 ng/mL; P = 0.001). Composite MACE occurred in 12 patients with high myeloperoxidase levels (33%) and in 4 patients with low myeloperoxidase levels (11%) (P = 0.02). The incidences of nonfatal recurrent myocardial infarction and verified cardiac death were higher in the high-myeloperoxidase group. In multivariate analysis, high plasma myeloperoxidase levels were independent predictors of MACE (odds ratio = 3.843; <95% confidence interval, 1.625-6.563; P = 0.003). High plasma myeloperoxidase levels identify patients with a worse prognosis after acute STEMI at 2-year follow-up. Evaluation of plasma myeloperoxidase levels might be useful in determining patients at high risk of death and MACE who can benefit from further aggressive treatment and closer follow-up.