Abstract 1706: Elevated Plasma Myleoperoxidase as Indicator for Vulnerable Plaque in Stable Patients With Diabetes Mellitus
Background: Myeloperoxidase (MPO) has been associated with increased cardiovascular risk of adverse long-term outcomes in acute coronary syndromes and in community based screenings. Our objective is to further examine the ability of plasma MPO in predicting events associated with plaque vulnerability (non-fatal MI and stroke) according to the presence or absence of diabetes mellitus (DM).
Methods: We examined plasma MPO levels in 4,063 subjects who underwent elective cardiac evaluation with coronary angiography who had completed 3 years of follow-up, and stratified according to their glycemic control status at baseline (DM, impaired fasting glucose [IFG] at 100 –126 mg/dL, or normal fasting glucose [NFG] at <100 mg/dL). Subjects were followed up to 3 years prospectively for major adverse cardiac events (MACE, including death, non-fatal myocardial infarction [MI], or stroke).
Results: In our study population (mean age 63 ± 11 years, 66% male, 28% with DM, 30% with IFG), higher log-transformed plasma MPO levels was associated with higher 3-year MACE (Hazard ratio 1.23, 95%CI 1.13–1.33, p < 0.001). MPO serves as strong predictor of incident MACE over ensuing 3 year interval among DM, IFG, and NFG alike (Figure⇓). Furthermore, incident risks for non-fatal MI/stroke are pronounced in top MPO quartile among DM subjects (11.7% vs 6.6% for 4th vs 1st Quartile; p < 0.01), while that in the lowest MPO level were comparable to non-DM subjects (6.6% vs 5.6% for DM vs NFG, p = ns).
Conclusions: Elevated MPO levels may indicate plaque vulnerability in stable patients with diabetes mellitus.