title: Plasma Myeloperoxidase and Total Sialic Acid as Prognostic Indicators in Acute Coronary Syndrome.
abstract: BACKGROUND
  Acute Coronary Syndrome (ACS) is the leading cause of death worldwide. Oxidative stress and inflammation play important role in the destabilization of plaques leading to ACS. Markers which reflect this pathophysiologic mechanism may have prognostic value. Myeloperoxidase (MPO) and Sialic acid are markers of inflammation and oxidative stress. Both these markers are increased in patients with ACS. Their prognostic value in ACS is not well established.
  
  
  OBJECTIVE
  To analyse the prognostic value of plasma myeloperoxidase and total sialic acid levels in patients with suspected acute coronary syndrome.
  
  
  METHODS
  A prospective study was conducted on 93 consecutively admitted patients with chest pain from July 2011 to September 2011. Plasma MPO and total sialic acid levels on admission were estimated spectrophotometrically. These were compared with extent of disease, development of complications during the hospital stay, left ventricular ejection fraction and mean duration of stay in hospital.
  
  
  RESULTS
  Plasma MPO and total sialic acid levels were significantly higher in patients with myocardial infarction than those with unstable and stable angina (p<0.001 and p<0.007 respectively). The levels of plasma MPO and sialic acid levels were significantly higher in patients who developed complications like heart failure, arrhythmias, renal failure during their stay in hospital (p<0.011 and p<0.006 respectively). Ejection fraction was significantly low in patients with high MPO levels (p<0.011).
  
  
  CONCLUSIONS
  In patients with ACS, plasma MPO and total sialic acid levels on admission could predict the development of complications during their hospital stay. MPO levels correlated with ejection fraction in patients with ACS.
authors.affiliation: Assistant Professor, Department of Biochemistry, PSG Institute of Medical Sciences and Research , Coimbatore, Tamil Nadu, India .
authors.forename: Sumitra
authors.initials: S
authors.lastname: Govindarajan
authors.affiliation: Biochemist Incharge, IQRAA International Hospital and Research centre , Calicut, Kerala, India .
authors.forename: Vm Mithun
authors.initials: VM
authors.lastname: Raghavan
authors.affiliation: Medical Biochemist/ Quality Manager, Elbit Diagnostics , Bangalore, Karnataka, India .
authors.forename: Anand C Vasudeva
authors.initials: AC
authors.lastname: Rao
keywords: Left ventricular ejection fraction; Major adverse cardiac event; Myocardial infarction