Department of Medicine II, Heart Center Bonn, University Hospital Bonn, Bonn, Germany.
Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany.
Vascular. 2021 Jun;29(3):363-371. doi: 10.1177/1708538120957491. Epub 2020 Sep 14.
The involvement of myeloperoxidase in the production of dysfunctional high-density lipoproteins and oxidised biomolecules leads to oxidative stress in the blood vessel endothelium. This prospective cohort study aimed to examine the prognostic value of myeloperoxidase in patients with peripheral artery disease in relation to major adverse cardiac events (MACEs), target lesion revascularisation, and major adverse limb events (MALEs) and its association with multi-bed vascular disease, which is defined as any combination of the following: peripheral artery disease and coronary artery disease.
Myeloperoxidase levels were measured in patients with peripheral artery disease and coronary artery disease during angiography. A total of 94 patients were analysed and followed up regarding their MACEs, target lesion revascularisation, and MALEs from August 2016 until February 2019.
Among patients with peripheral artery disease, the rates of MACE and mortality were higher in patients with high myeloperoxidase levels than in those with low myeloperoxidase levels; the myeloperoxidase levels were 3.68 times higher in these patients ( < 0.0001). Patients with peripheral artery disease and coronary artery disease (multi-bed vascular disease) had higher myeloperoxidase levels than those with only peripheral artery disease and only coronary artery disease (one-bed vascular disease). Peripheral artery disease patients with higher myeloperoxidase levels had significantly higher rates of limb ischaemia, requiring further revascularisation than those with low myeloperoxidase levels.
High myeloperoxidase levels suggest poor outcomes and are associated with MACE and limb ischaemia. Our findings indicated that myeloperoxidase levels could become a prognostic marker and may be used in conjunction with other methods for risk stratification in patients with peripheral artery disease and multi-bed vascular disease.
髓过氧化物酶参与产生功能失调的高密度脂蛋白和氧化生物分子，导致血管内皮的氧化应激。这项前瞻性队列研究旨在检查髓过氧化物酶在周围动脉疾病患者中的预后价值，与主要不良心脏事件（MACEs）、靶病变血运重建和主要不良肢体事件（MALEs）相关，并探讨其与多床位血管疾病的关系，多床位血管疾病定义为以下任何组合：周围动脉疾病和冠状动脉疾病。
在血管造影期间测量了患有周围动脉疾病和冠状动脉疾病的患者的髓过氧化物酶水平。共分析了 94 例患者，并对其从 2016 年 8 月至 2019 年 2 月的 MACEs、靶病变血运重建和 MALEs 进行了随访。
在患有周围动脉疾病的患者中，高水平髓过氧化物酶的患者的 MACE 和死亡率高于低水平髓过氧化物酶的患者；这些患者的髓过氧化物酶水平高 3.68 倍（<0.0001）。患有周围动脉疾病和冠状动脉疾病（多床位血管疾病）的患者的髓过氧化物酶水平高于仅患有周围动脉疾病和仅患有冠状动脉疾病的患者（单床位血管疾病）。高水平髓过氧化物酶的周围动脉疾病患者的肢体缺血发生率明显高于低水平髓过氧化物酶的患者，需要进一步血运重建。
高水平的髓过氧化物酶提示预后不良，与 MACE 和肢体缺血相关。我们的研究结果表明，髓过氧化物酶水平可能成为一种预后标志物，并可能与其他方法一起用于周围动脉疾病和多床位血管疾病患者的风险分层。
