Plasma myeloperoxidase concentration predicts the presence and severity of coronary disease in patients with chest pain and negative troponin-T

Coronary Artery DiseaseRebeiz AG et al. | November 29, 2011

Among patients with chest pain without troponin elevation, a single measurement of plasma myeloperoxidase (MPO) concentration can help identify patients with a higher risk of having significant coronary stenoses and high–risk angiographic features.

Methods

  • Patients presenting with chest pain and negative cardiac troponin–T concentration and undergoing coronary angiography were enrolled in this study.
  • Plasma MPO concentration was measured using a single blood sample collected prior to cardiac catheterization.
  • The primary angiographic endpoint was the presence of at least one coronary stenosis causing a 70% or more diameter reduction; secondary endpoints were number of diseased vessels, presence of coronary thrombus, and lesion ulceration.
  • The main clinical endpoint was coronary revascularization.

Results

  • 389 patients were enrolled.
  • Presence of coronary stenosis causing a 70% or more diameter reduction increased with increasing quartiles of myeloperoxidase concentration (P<0.0001), as did the presence of coronary thrombus (P<0.0001) and plaque ulceration (P<0.0001).
  • The need for percutaneous coronary revascularization also increased with increasing quartiles of systemic myeloperoxidase levels (P<0.0001).
  • Coronary surgical revascularization did not differ among myeloperoxidase quartiles.

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