Department of Cardiology, Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Clin Cardiol. 2021 Mar;44(3):357-363. doi: 10.1002/clc.23542. Epub 2021 Jan 6.
Myeloperoxidase (MPO) secreted by neutrophils is the enzyme that kills bacteria and other pathogens. Acute myocardial infarction (AMI) is usually caused by thrombosis in response to vulnerable plaque rupture. Circulating MPO was found to be associated with increased mortality in AMI patients. However, the relationship between MPO in thrombi and the prognosis of AMI patients remains unknown.
MPO expression in thrombi is associated with the prognosis of patients who underwent primary percutaneous coronary intervention (PCI) after AMI.
This study included 41 consecutive patients with acute ST-elevation myocardial infarction, who successfully underwent primary PCI, during which we collected thrombi remaining in the culprit artery using aspiration catheters. These thrombus samples were fixed, and immunohistochemical staining against MPO and heme oxygenase-1 (HO-1) was conducted. Enrolled patients were divided into two groups based on the induction of thrombotic MPO, which was quantified using Image J software.
We observed that increased MPO was associated with lower left ventricular ejection fraction (LVEF) and worse LV remodeling in AMI patients. Instead, patients with decreased thrombotic MPO induction had a considerable improvement in LVEF 1 month after discharge (54.4 ± 2.0% vs. 61.1 ± 2.3%, p < 0.01). In the MPO group, a reduction in the thrombotic HO-1 level contributed to the development of adverse LV remodeling. Logistic regression showed that MPO was a considerable risk factor for adverse LV remodeling (adjusted OR 3.70, p < 0.05).
MPO expression in thrombi is associated with reduced LVEF and deteriorated LV remodeling in AMI patients, which may be due to HO-1 suppression in thrombi.
中性粒细胞分泌的髓过氧化物酶（MPO）是杀死细菌和其他病原体的酶。急性心肌梗死（AMI）通常是由对易损斑块破裂的血栓反应引起的。循环 MPO 被发现与 AMI 患者的死亡率增加有关。然而，血栓中 MPO 与 AMI 患者预后之间的关系尚不清楚。
血栓中 MPO 的表达与接受 AMI 后经皮冠状动脉介入治疗（PCI）的患者的预后有关。
本研究纳入了 41 例急性 ST 段抬高型心肌梗死患者，他们成功接受了经皮冠状动脉介入治疗，在此期间，我们使用抽吸导管收集了罪犯动脉中残留的血栓。这些血栓样本被固定，并进行了针对髓过氧化物酶和血红素加氧酶-1（HO-1）的免疫组织化学染色。根据 Image J 软件定量的血栓形成 MPO 诱导，将入组患者分为两组。
我们观察到，在 AMI 患者中，MPO 的增加与左心室射血分数（LVEF）降低和 LV 重构恶化有关。相反，血栓形成 MPO 诱导减少的患者在出院后 1 个月时 LVEF 有显著改善（54.4±2.0%比 61.1±2.3%，p<0.01）。在 MPO 组中，血栓中 HO-1 水平的降低导致不良 LV 重构的发生。Logistic 回归显示 MPO 是不良 LV 重构的一个重要危险因素（调整后的 OR 3.70，p<0.05）。
血栓中 MPO 的表达与 AMI 患者的 LVEF 降低和 LV 重构恶化有关，这可能是由于血栓中 HO-1 的抑制。
