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Level and prognostic value of serum myeloperoxidase in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention.

BACKGROUND
This study tested the hypothesis that the baseline plasma level of myeloperoxidase (MPO) independently predicts risk of patients with ST-segment elevation (ST-se) acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI).


METHODS AND RESULTS
Plasma MPO levels in 128 patients were examined by ELISA. They were significantly higher in AMI patients than in normal controls (P<0.0001). Patients with a high plasma MPO level (>or=1,150 ng/ml) had significantly higher white blood cell counts, a higher plasma level of oxidized low-density lipoprotein, higher peak MB fraction of creatine kinase level, significantly lower left ventricular ejection fraction, and significantly higher incidence of 30-day composite major adverse clinical events (MACE) (defined as Killip score>or=3, re-infarction, repeat PCI, or 30-day mortality) than those patients with low plasma MPO level (<1,150 ng/ml) (all P<0.001). Multiple stepwise logistic regression analysis demonstrated that high plasma MPO level (>or=1,150 pg/ml) was the most independent predictor of 30-day MACE (P<0.0001).


CONCLUSIONS
Plasma MPO level is a major independent inflammatory predictor of 30-day MACE in ST-se AMI patients. Evaluation of the circulating MPO level might improve the prediction of unfavorable clinical outcome following AMI.