Myeloperoxidase in Patients with Acute Myocardial Infarction
Daftar Isi:
- Inflammation has been linked to all stages of the development of vulnerable plaque which not only causes platelet activation but also proceeded by activation of polymorphonuclear neutrophils (PMNs). Myeloperoxidase (MPO), a hemoprotein expressed by PMNs and secreted during activation. Among predictors of major adverse cardiovascular events (MACE) that have been widely used and known, such as hs-CRP and Troponin T, it is still unknown whether MPO also provides prognostic information in patients with acute myocardial infarction (AMI). This study was aimed to evaluate the predictive value of MPO and to compare MPO with hs-CRP and Troponin T as predictor of MACE in patients with AMI. A prospective cohort study was conducted from April to June 2006 at the emergency department of Harapan Kita, National Cardiovascular Centre (HK-NCVC), Jakarta. MPO, hs-CRP, and troponin T serum levels were assessed in 93 patients with AMI. Data on death, re-infarctions, angina, revascularization, and heart failure was collected during 6 months of follow-up. Patients with MPO serum level >204,9ìg/l had increased risk of cardiovascular events (HR 6.76; 95%CI 3.37-13.56, p<0.001). MPO (sensitivity 83.1%; specificity 82.4%) was a stronger independent predictor for subsequent cardiovascular events than Troponin T (sensitivity 59.8%; specificity 71.6%) and hs-CRP (sensitivity 48.5%; specificity 46.1%). In patients with AMI, MPO serum levels powerfully predicted an increased risk for subsequent cardiovascular events.Keywords: acute myocardial infarction, cardiovascular events, inflamation, myeloperoxidase, prognosis