Abstract 5512: Plasma Myeloperoxidase is Independent Predictor of Incident Major Adverse Clinical Events in Stable Patients Undergoing Elective Coronary Angiography
Background: Myeloperoxidase (MPO) has been shown to predict adverse clinical outcomes in the setting of acute coronary syndrome. Its prognostic role in stable patients undergoing evaluation of coronary artery disease is uncertain.
Methods: We examined plasma MPO levels and their relationship with incident major adverse cardiovascular events (MACE, including death, myocardial infarction, and stroke) over prospective 3-year follow-up in 2,588 patients undergoing elective coronary angiography without myocardial infarction (cTnI <0.03 ng/mL). MPO was measured in EDTA plasma using the Abbott Architect platform (Abbott Diagnostics Inc, Abbott Park IL).
Results: In our cohort (mean age 63 years, 64% male, 68% with hypertension, 30% with diabetes mellitus), the mean and median plasma MPO level were 200±285 pmol/L and 103 pmol/L, respectively. Patients with plasma MPO levels greater than the upper limit of normal (425 pmol/L, 12% of cohort, normal range derived from independent cohort of 305 healthy subjects aged 30–90 years) had a 1.6-fold increased risk in incident MACE (HR 1.56, 95%CI 1.14–2.13, p=0.006). After adjusting for traditional risk factors including Framingham risk score, creatinine clearance, B-type natriuretic peptide, and cardiac troponin I, MPO levels 425 pmol/L or higher remained significantly associated with more incident major long-term major adverse cardiac events (Hazard ratio 1.47; 95%CI 1.07–2.01, p=0.017).
Conclusion: Plasma MPO levels provide independent prognostic value for predicting long-term incident MACE in stable patients undergoing elective coronary evaluation.