BACKGROUND: Inflammation plays a critical role in acute myocardial infarction (MI). One such inflammatory marker is myeloperoxidase (MPO). Its role as a predictor of death or MI in patients with ST segment elevation myocardial infarction (STEMI) is unclear. AIM: To investigate the role of MPO as a predictor of death or MI in patients with STEMI and to compare it with N-terminal pro-B-type natriuretic peptide (NT-BNP). METHOD: 384 post STEMI patients were studied. Patients were followed up for the combined end point of death or readmission with non-fatal MI. RESULTS: There were 40 deaths and 37 readmissions with MI. Median MPO was raised in patients experiencing death or MI than in survivors (median (range), 50.6 (15.3-124.1) ng/ml vs 33.5 (6.6-400.2) ng/ml, p = 0.001). Using a Cox proportional hazards model, log median MPO (HR 6.91, 95% CI 1.79 to 26.73, p = 0.005) and log median NT-BNP (HR 4.21, 95% CI 1.53 to 11.58, p = 0.005) independently predicted death or non-fatal MI. MPO had predictive power in both below and above median NT-BNP levels (log rank 5.60, p = 0.020 and log rank 5.12, p = 0.024, respectively). The receiver-operating curve for median NT-BNP yielded an area under the curve (AUC) of 0.72 (95% CI 0.65 to 0.79, p<0.001); for median MPO, the AUC was 0.62 (95% CI 0.55 to 0.69, p = 0.001). The logistic model combining the two markers yielded an AUC of 0.76 (95% CI 0.69 to 0.82, p<0.001). CONCLUSION: MPO and NT-BNP may be useful tools for risk stratification of all acute coronary syndromes, including patients with STEMI at higher risk.
BACKGROUND: Inflammation plays a critical role in acute myocardial infarction (MI). One such inflammatory marker is myeloperoxidase (MPO). Its role as a predictor of death or MI in patients with ST segment elevation myocardial infarction (STEMI) is unclear. AIM: To investigate the role of MPO as a predictor of death or MI in patients with STEMI and to compare it with N-terminal pro-B-type natriuretic peptide (NT-BNP). METHOD: 384 post STEMI patients were studied. Patients were followed up for the combined end point of death or readmission with non-fatal MI. RESULTS: There were 40 deaths and 37 readmissions with MI. Median MPO was raised in patients experiencing death or MI than in survivors (median (range), 50.6 (15.3-124.1) ng/ml vs 33.5 (6.6-400.2) ng/ml, p = 0.001). Using a Cox proportional hazards model, log median MPO (HR 6.91, 95% CI 1.79 to 26.73, p = 0.005) and log median NT-BNP (HR 4.21, 95% CI 1.53 to 11.58, p = 0.005) independently predicted death or non-fatal MI. MPO had predictive power in both below and above median NT-BNP levels (log rank 5.60, p = 0.020 and log rank 5.12, p = 0.024, respectively). The receiver-operating curve for median NT-BNP yielded an area under the curve (AUC) of 0.72 (95% CI 0.65 to 0.79, p<0.001); for median MPO, the AUC was 0.62 (95% CI 0.55 to 0.69, p = 0.001). The logistic model combining the two markers yielded an AUC of 0.76 (95% CI 0.69 to 0.82, p<0.001). CONCLUSION:MPO and NT-BNP may be useful tools for risk stratification of all acute coronary syndromes, including patients with STEMI at higher risk.
Authors: Takahiko Naruko; Makiko Ueda; Kazuo Haze; Allard C van der Wal; Chris M van der Loos; Akira Itoh; Ryushi Komatsu; Yoshihiro Ikura; Masayuki Ogami; Yoshihisa Shimada; Shoichi Ehara; Minoru Yoshiyama; Kazuhide Takeuchi; Junichi Yoshikawa; Anton E Becker Journal: Circulation Date: 2002-12-03 Impact factor: 29.690
Authors: R Zhang; M L Brennan; X Fu; R J Aviles; G L Pearce; M S Penn; E J Topol; D L Sprecher; S L Hazen Journal: JAMA Date: 2001-11-07 Impact factor: 56.272
Authors: Marc S Sabatine; David A Morrow; James A de Lemos; C Michael Gibson; Sabina A Murphy; Nader Rifai; Carolyn McCabe; Elliott M Antman; Christopher P Cannon; Eugene Braunwald Journal: Circulation Date: 2002-04-16 Impact factor: 29.690
Authors: Antonino Buffon; Luigi M Biasucci; Giovanna Liuzzo; Giuseppe D'Onofrio; Filippo Crea; Attilio Maseri Journal: N Engl J Med Date: 2002-07-04 Impact factor: 91.245
Authors: Jason P Eiserich; Stephan Baldus; Marie-Luise Brennan; Wenxin Ma; Chunxiang Zhang; Albert Tousson; Laura Castro; Aldons J Lusis; William M Nauseef; C Roger White; Bruce A Freeman Journal: Science Date: 2002-06-28 Impact factor: 47.728
Authors: Ming-Lin Zhu; Jin-Ping Zhao; Ning Cui; Victor H Gonçalves-Rizzi; Jose S Possomato-Vieira; Regina A Nascimento; Carlos A Dias-Junior Journal: J Huazhong Univ Sci Technolog Med Sci Date: 2017-12-21
Authors: Robin E Gandley; Jennifer Rohland; Yan Zhou; Eiji Shibata; Gail F Harger; Augustine Rajakumar; Valerian E Kagan; Nina Markovic; Carl A Hubel Journal: Hypertension Date: 2008-06-30 Impact factor: 10.190