title: Usefulness of baseline plasma myeloperoxidase levels as an independent predictor of myocardial infarction at two years in patients presenting with acute coronary syndrome.
abstract: Baseline plasma myeloperoxidase (MPO) levels have been shown to independently predict the early risk of myocardial infarction (MI) in patients presenting with chest pain. In addition, baseline MPO levels have been demonstrated to predict the development of adverse cardiac events up to 6 months after an acute coronary syndrome (ACS). However, in contrast to other biomarkers, there are no data about the long-term independent predictive value of baseline MPO values in patients with ACS. The present study investigated the long-term prognostic significance of baseline MPO levels in a well-characterized cohort of 193 men with ACS who were referred for coronary angiography at a Veterans Administration Medical Center. All patients were followed prospectively for the development of death and MI, and follow-up data were available for all patients at 24 months. After controlling for different baseline clinical, laboratory, and angiographic variables, baseline plasma MPO values were a strong and independent predictor of MI at 24 months by multivariate analysis. Using the median MPO value of the entire cohort of patients (i.e., 20.34 ng/ml) as a prespecified cutoff, the MI-free survival at 24 months for the group whose baseline MPO values were < or =20.34 ng/ml was 88% compared with 74% in those whose values were >20.34 ng/ml (p = 0.0249 by log-rank test). In conclusion, these data demonstrate that baseline MPO levels independently predict MI at 2 years in patients with ACS.
authors.affiliation: Division of Cardiology, Department of Medicine, SUNY Downstate Medical Center, Brooklyn, New York, USA. e.cavusoglu@aol.com
authors.forename: Erdal
authors.initials: E
authors.lastname: Cavusoglu
authors.forename: Cyril
authors.initials: C
authors.lastname: Ruwende
authors.forename: Calvin
authors.initials: C
authors.lastname: Eng
authors.forename: Vineet
authors.initials: V
authors.lastname: Chopra
authors.forename: Sunitha
authors.initials: S
authors.lastname: Yanamadala
authors.forename: Luther T
authors.initials: LT
authors.lastname: Clark
authors.forename: David J
authors.initials: DJ
authors.lastname: Pinsky
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Marmur
mesh_terms: D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000201:enzymology*; D018572:Disease-Free Survival; D004797:Enzyme-Linked Immunosorbent Assay; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000000981:diagnostic imaging / Q000201:enzymology* / Q000209:etiology; D009195:Peroxidase / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012107:Research Design; D012307:Risk Factors; D013577:Syndrome; D013997:Time Factors; D019210:Troponin I / Q000097:blood
chemical_list: D015415:Biomarkers; D019210:Troponin I; D002097:C-Reactive Protein; D009195:Peroxidase