title: Usefulness of serum myeloperoxidase in prediction of mortality in patients with severe heart failure.
abstract: BACKGROUND
  Myeloperoxidase levels were shown to reflect endothelial dysfunction, inflammation, atherosclerosis and oxidative stress.
  
  
  OBJECTIVE
  To examine the role of circulating myeloperoxidase, a leukocyte-derived enzyme, as a predictor of mortality in patients with congestive heart failure.
  
  
  METHODS
  Baseline serum MPO levels were measured in 285 consecutive CHF patients and 35 healthy volunteers. N-terminal pro-brain natriuretic peptide and high sensitivity C-reactive protein concentrations were also measured. The primary outcome endpoint was overall mortality.
  
  
  RESULTS
  MPO levels were significantly elevated in patients with CHF compared to healthy volunteers (P = 0.01). During a mean follow-up of 40.9 +/- 11.3 months there were 106 deaths. On a univariate Cox regression analysis MPO levels were of marginal value (P = 0.07) whereas NT-proBNP was of considerable value (P < 0.0001) in predicting all-cause mortality. By dividing our cohort according to NT-proBNP levels into high, intermediate and low risk groups a clear difference in mortality was shown. By further dividing the patient cohort according to MPO levels above or below the median (122.5 ng/ml), mortality prediction improved in the patients with intermediate NT-proBNP values.
  
  
  CONCLUSIONS
  MPO levels are elevated in CHF and correlate with disease severity. MPO has an additive predictive value on mortality in patients with intermediate NT-proBNP levels.
authors.affiliation: Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Yoav
authors.initials: Y
authors.lastname: Michowitz
authors.forename: Sarina
authors.initials: S
authors.lastname: Kisil
authors.forename: Hanan
authors.initials: H
authors.lastname: Guzner-Gur
authors.forename: Ardon
authors.initials: A
authors.lastname: Rubinstein
authors.forename: Dov
authors.initials: D
authors.lastname: Wexler
authors.forename: David
authors.initials: D
authors.lastname: Sheps
authors.forename: Gad
authors.initials: G
authors.lastname: Keren
authors.forename: Jacob
authors.initials: J
authors.lastname: George
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000145:classification / Q000401:mortality*; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood; D018384:Oxidative Stress; D010446:Peptide Fragments / Q000097:blood; D009195:Peroxidase / Q000097:blood*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein; D009195:Peroxidase