Abstract 3615: Prognostic Value of Plasma Myeloperoxidase Levels Across the Spectrum of Systolic and Diastolic Dysfunction in Patients with Chronic Systolic Heart Failure
Background: Myeloperoxidase (MPO) is an inflammatory marker with mechanistic links to plaque vulnerability and abnormal ventricular remodeling. The relationship between MPO and the long-term prognosis of patients with chronic heart failure (HF) with systolic or diastolic dysfunction is unknown.
Methods: We evaluated plasma MPO levels (CardioMPO, PrognostiX) in 140 patients with chronic systolic HF (LV ejection fraction [EF] <35%) from the ADEPT study with varying degrees of diastolic dysfunction. We examined the relationships between plasma MPO levels, echocardiographic indices of systolic and diastolic dysfunction, and long-term clinical outcomes (death, cardiac transplantation, or HF hospitalization).
Results: Increasing quartiles of MPO levels correspond to increasing likelihood of more advanced heart failure (LVEF<25%, restrictive diastolic stage, RV systolic dysfunction). MPO levels were predictive of incident mortality, HF hospitalization, and cardiac transplantation (OR (95% CI) = 1.44 (1.09 – 1.93)) within the whole cohort. Elevated MPO levels provided additive prognostic detection of adverse outcomes in HF patients with high BNP levels and impaired systolic and diastolic performance (see Figure⇓). MPO remained a significant predictor of mortality, HF hospitalization, and cardiac transplantation following adjustment for age, LVEF, diastolic stage, NYHA class, and plasma BNP level.
Conclusion: In patients with chronic HF, increased plasma MPO levels are associated with more advanced indices of systolic and diastolic dysfunction, and are an independent predictor of increased risk for HF hospitalization, cardiac transplantation or death.