Turk Kardiyol Dern Ars. 2005; 33(8): 452-459

The relationship between serum myeloperoxidase levels and major cardiovascular events in patients with acute coronary syndrome

Şakir Arslan¹, M.Kemal Erol¹, Ahmet Kızıltunç², Engin Bozkurt¹, H.Yekta Gürlertop^1
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OBJECTIVES
This study was planned to assess the relationship between serum myeloperoxidase (MPO) levels and major cardiovascular events in patients with acute coronary syndrome.
STUDY DESIGN
Serum MPO levels were measured by ELISA on admission of 243 consecutive patients with acute coronary syndrome (153 acute myocardial infarction, 90 unstable angina). Major cardiac events that occurred during hospitalization and 30-day follow-up period included recurrent angina, reinfarction, ventricular (ventricular tachycardia, ventricular fibrillation) and supraventricular (atrial fibrillation, supraventricular tachycardia) arrhythmias, complete atrioventricular block, clinical heart failure, and death. Correlations were sought between high (n=70, >350 µg/l) and low (n=173, ?350 µg/l) MPO levels and major events. Relative risks were estimated using the Cox proportional hazards regression model.
RESULTS
The incidence of hypercholesterolemia was significantly higher in patients with high levels of MPO (p=0.008). A significant association was found between high levels of MPO and increased mortality risk during both hospitalization (hazard ratio-HR, 3.91; 95% CI 1.12-13.6; p=0.03) and 30-day follow-up period (HR 5.08, 95% CI 1.64-15.7; p=0.005). No significant differences were observed between patients with high and low MPO levels with respect to the development of arrhythmia, reinfarction, recurrent angina, and clinical heart failure (p>0.05).
CONCLUSION
The results of this study demonstrate that elevated MPO levels predict death during hospital stay and 30-day follow-up period in patients with acute coronary syndrome.

Keywords: Biological markers/blood; chest pain/enzymology; coronary disease/blood/enzymology; coronary thrombosis; inflammation mediators/blood; isoenzymes/blood; myocardial infarction; peroxidase/blood

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