Samimi-Fard Sima, Dominguez-Rodriguez Alberto, Abreu-Gonzalez Pedro, Enjuanes-Grau Cristina, Blanco-Palacios Gabriela, Hernandez-Baldomero Idaira F, Bosa-Ojeda Francisco, Marrero-Rodríguez Francisco
Department of Cardiology, University Hospital of Canarias, Tenerife, Spain.
Am J Cardiol. 2009 Sep 1;104(5):634-7. doi: 10.1016/j.amjcard.2009.04.049. Epub 2009 Jun 24.
Elevated cytokine levels have been reported after ischemia/reperfusion injury and might cause a systemic inflammatory response syndrome (SIRS) after primary percutaneous coronary intervention (PPCI). High myeloperoxidase (MPO) levels are reported to be a risk factor for early cardiac events in patients with acute coronary syndrome. Its role as a predictor of SIRS in patients with ST-segment elevation myocardial infarction treated with PPCI is unclear. Therefore, the aim of the present study was to investigate the role of MPO as a predictor of SIRS in patients with ST-segment elevation myocardial infarction treated with PPCI. A total of 250 patients with ST-segment elevation myocardial infarction treated with PPCI were admitted to our coronary care unit. The serum MPO levels were measured at admission using a commercially available enzyme-linked immunosorbent assay. Of the 250 patients, 47 developed SIRS within 48 hours after their admission to the coronary care unit; 10 of these patients were excluded from analysis because of the suspicion of sepsis. The remaining 203 patients had no SIRS during their coronary care unit stay. Compared to patients without SIRS, those with SIRS had greater serum MPO values (81.35 +/- 18.07 vs 67.03 +/- 16.98 ng/ml, p <0.0001) after PPCI. After controlling for different baseline clinical, laboratory, and angiographic variables, the baseline serum MPO levels were an independent predictor of SIRS (odds ratio 4.2, 95% confidence interval 1.9 to 8.4, p <0.001). In conclusion, our results have demonstrated that MPO is an independent predictor of SIRS after PPCI, suggesting a new clue for the interpretation of this phenomenon.
据报道，缺血/再灌注损伤后细胞因子水平会升高，这可能会在直接经皮冠状动脉介入治疗（PPCI）后引发全身炎症反应综合征（SIRS）。据报道，高髓过氧化物酶（MPO）水平是急性冠状动脉综合征患者早期心脏事件的危险因素。其作为接受PPCI治疗的ST段抬高型心肌梗死患者发生SIRS的预测指标的作用尚不清楚。因此，本研究的目的是探讨MPO作为接受PPCI治疗的ST段抬高型心肌梗死患者发生SIRS的预测指标的作用。共有250例接受PPCI治疗的ST段抬高型心肌梗死患者入住我们的冠心病监护病房。入院时使用市售酶联免疫吸附测定法测量血清MPO水平。在这250例患者中，47例在入住冠心病监护病房后48小时内发生SIRS；其中10例患者因怀疑脓毒症而被排除在分析之外。其余203例患者在冠心病监护病房住院期间未发生SIRS。与未发生SIRS的患者相比，发生SIRS的患者在PPCI后血清MPO值更高（81.35±18.07 vs 67.03±16.98 ng/ml，p<0.0001）。在控制了不同的基线临床、实验室和血管造影变量后，基线血清MPO水平是SIRS的独立预测指标（优势比4.2，95%置信区间1.9至8.4，p<0.001）。总之，我们的结果表明，MPO是PPCI后SIRS的独立预测指标，为解释这一现象提供了新线索。
