Kaya Mehmet Gungor, Yalcin Ridvan, Okyay Kaan, Poyraz Fatih, Bayraktar Nilufer, Pasaoglu Hatice, Boyaci Bulent, Cengel Atiye
Department of Cardiology, Erciyes University School of Medicine, 38039 Kayseri, Turkey.
Tex Heart Inst J. 2012;39(4):500-6.
We investigated the prognostic importance of plasma myeloperoxidase levels in patients with ST-elevation myocardial infarction (STEMI) at long-term follow-up, and we analyzed the correlations between plasma myeloperoxidase levels and other biochemical values. We evaluated 73 consecutive patients (56 men; mean age, 56 ± 11 yr) diagnosed with acute STEMI and 46 age- and sex-matched healthy control participants. Patients were divided into 2 groups according to the median myeloperoxidase level (Group 1: plasma myeloperoxidase ≤ 68 ng/mL; and Group 2: plasma myeloperoxidase > 68 ng/mL). Patients were monitored for the occurrence of major adverse cardiovascular events (MACE), which were defined as cardiac death; reinfarction; new hospital admission for angina; heart failure; and revascularization procedures. The mean follow-up period was 25 ± 16 months. Plasma myeloperoxidase levels were higher in STEMI patients than in control participants (82 ± 34 vs 20 ± 12 ng/mL; P = 0.001). Composite MACE occurred in 12 patients with high myeloperoxidase levels (33%) and in 4 patients with low myeloperoxidase levels (11%) (P = 0.02). The incidences of nonfatal recurrent myocardial infarction and verified cardiac death were higher in the high-myeloperoxidase group. In multivariate analysis, high plasma myeloperoxidase levels were independent predictors of MACE (odds ratio = 3.843; <95% confidence interval, 1.625-6.563; P = 0.003). High plasma myeloperoxidase levels identify patients with a worse prognosis after acute STEMI at 2-year follow-up. Evaluation of plasma myeloperoxidase levels might be useful in determining patients at high risk of death and MACE who can benefit from further aggressive treatment and closer follow-up.
我们在长期随访中研究了血浆髓过氧化物酶水平对ST段抬高型心肌梗死（STEMI）患者预后的重要性，并分析了血浆髓过氧化物酶水平与其他生化指标之间的相关性。我们评估了73例连续诊断为急性STEMI的患者（56例男性；平均年龄56±11岁）以及46例年龄和性别匹配的健康对照者。根据髓过氧化物酶水平中位数将患者分为2组（第1组：血浆髓过氧化物酶≤68 ng/mL；第2组：血浆髓过氧化物酶>68 ng/mL）。对患者进行主要不良心血管事件（MACE）发生情况的监测，MACE定义为心源性死亡、再梗死、因心绞痛再次住院、心力衰竭以及血运重建手术。平均随访时间为25±16个月。STEMI患者的血浆髓过氧化物酶水平高于对照者（82±34 vs 20±12 ng/mL；P = 0.001）。12例髓过氧化物酶水平高的患者发生了复合MACE（33%），4例髓过氧化物酶水平低的患者发生了复合MACE（11%）（P = 0.02）。高髓过氧化物酶水平组非致命性复发性心肌梗死和经证实的心源性死亡发生率更高。在多变量分析中，高血浆髓过氧化物酶水平是MACE的独立预测因素（比值比 = 3.843；95%置信区间，1.625 - 6.563；P = 0.003）。高血浆髓过氧化物酶水平可识别出急性STEMI后2年随访中预后较差的患者。评估血浆髓过氧化物酶水平可能有助于确定那些能从进一步积极治疗和密切随访中获益的、有高死亡风险和MACE风险的患者。
