Kacprzak Michal, Zielinska Marzenna
Intensive Cardiac Therapy Clinic, Medical University of Lodz, Poland.
Intensive Cardiac Therapy Clinic, Medical University of Lodz, Poland.
Int J Cardiol. 2016 Nov 15;223:452-457. doi: 10.1016/j.ijcard.2016.07.258. Epub 2016 Aug 1.
Inflammation plays an important role on every stage of atherosclerosis. Myeloperoxidase (MPO), a leukocyte-derived enzyme that participates in the innate immunity, probably is involved in many stages of atherothrombosis. According to the recent studies, MPO is related with unfavorable outcome in patients with chest pain and acute coronary syndromes. Its role in prediction of outcomes after ST-segment elevation myocardial infarction (STEMI) remains unclear. The aim of the study was to assess if elevated MPO level is a predictor of long-term adverse cardiac events in patients with STEMI treated with primary percutaneous coronary intervention (pPCI).
We evaluated data of 127 patients with STEMI. Plasma levels of MPO collected on admission and the 3rd-4th day of hospitalization were measured by ELISA method. C-reactive protein (CRP) and N-terminal prohormone of B-type natriuretic peptide (NT-proBNP) were also determined. All patients were followed-up prospectively for the occurrence of major adverse cardiovascular events (MACE) defined as unscheduled coronary revascularization procedure, stroke, reinfarction or all-cause death.
After 14months of follow-up 20% of patients developed MACE. Elevated MPO levels collected on the 3rd-4th day of STEMI were the predictor of death, reinfarction, the need for coronary revascularization and all adverse events taken together. In multivariate analysis, MPO and CRP levels assessed on the 3rd-4th day of hospitalization revealed to be significant predictors of MACE. MPO demonstrated to be significantly better predictor of MACE than NT-proBNP level.
Myeloperoxidase is a prognostic marker in patients with STEMI treated with pPCI.
炎症在动脉粥样硬化的各个阶段都起着重要作用。髓过氧化物酶（MPO）是一种参与固有免疫的白细胞衍生酶，可能参与动脉粥样硬化血栓形成的多个阶段。根据最近的研究，MPO与胸痛和急性冠状动脉综合征患者的不良预后相关。其在ST段抬高型心肌梗死（STEMI）后预后预测中的作用仍不清楚。本研究的目的是评估MPO水平升高是否是接受直接经皮冠状动脉介入治疗（pPCI）的STEMI患者长期不良心脏事件的预测指标。
我们评估了127例STEMI患者的数据。采用酶联免疫吸附测定（ELISA）法测定入院时及住院第3 - 4天采集的血浆MPO水平。还测定了C反应蛋白（CRP）和B型利钠肽前体N末端（NT-proBNP）。对所有患者进行前瞻性随访，观察主要不良心血管事件（MACE）的发生情况，MACE定义为非计划性冠状动脉血运重建术、中风、再梗死或全因死亡。
随访14个月后，20%的患者发生了MACE。STEMI第3 - 4天采集的MPO水平升高是死亡、再梗死、冠状动脉血运重建需求以及所有不良事件的综合预测指标。在多变量分析中，住院第3 - 4天评估的MPO和CRP水平显示是MACE的显著预测指标。MPO被证明是比NT-proBNP水平更好的MACE预测指标。
髓过氧化物酶是接受pPCI治疗的STEMI患者的预后标志物。
