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.
- 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.
- 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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