Association of myeloperoxidase, homocysteine and high‑sensitivity C‑reactive protein with the severity of coronary artery disease and their diagnostic and prognostic value

Abstract

In the present study, the association between the severity of coronary artery disease (CAD) and myeloperoxidase (MPO), homocysteine (Hcy) and high-sensitivity C-reactive protein (hs-CRP) was assessed and their diagnostic and prognostic value was determined. A total of 112 patients with CAD [patient group (PG)] and 112 healthy participants who visited the hospital for physical examinations [control group (CG)] were enrolled in the present study. The plasma levels of MPO, Hcy and hs-CRP were compared between the two groups. According to the arteriography results, the patients were further divided into the single-vessel disease group (SVG), double-vessel disease group (DVG) and multi-vessel disease group (MVG). The Gensini scores of the three groups were evaluated according to the Gensini score standard. The correlations between the expression of MPO, Hcy or hs-CRP and the Gensini score of the PG were analyzed. The patients' major adverse cardiovascular event (MACEs) were recorded over 6 months and compared, and the predictive values of MPO, Hcy and hs-CRP regarding MACEs were determined by receiver operating characteristics analysis. The results indicated that the levels of MPO, Hcy and hs-CRP in the PG were higher than those in the CG (P<0.05). The Gensini score and the expression of MPO, Hcy and hs-CRP in the MVG were higher than those in the SVG and the DVG, and the Gensini score and the expression of MPO, Hcy and hs-CRP in the DVG were higher than those in the SVG (P<0.05). There was a positive correlation between the Gensini score and the expression of MPO (r=0.814, P<0.05), Hcy (r=0.774, P<0.05) and hs-CRP (r=0.765, P<0.05) in the PG. The total incidence of MACEs in patients with multiple lesions was significantly higher than that in patients with double and single lesions (P<0.05). The total incidence of MACEs in the MVG group was higher than that in the SVG and the DVG, and the total incidence of MACEs in the DVG was higher than that in the SVG (P<0.05). The area under the curve (AUC) and sensitivity for MPO levels to predict MACEs were higher than those of Hcy and hs-CRP (P<0.05); however, there was no significant difference in the AUC and sensitivity of Hcy and hs-CRP for predicting MACEs (P<0.05). The specificity of hs-CRP for predicting MACEs was higher than that of MPO and Hcy (P<0.05). The number of lesions, hypertension, diabetes, MPO, Hys and hs-CRP were determined to be independent risk factors for MACEs. In conclusion, for patients with CAD, elevated plasma levels of MPO, Hcy and hs-CRP were directly correlated with the severity of CAD and the risk of MACEs. Furthermore, MPO, Hcy and hs-CRP may effectively predict MACEs and are of important clinical significance in terms of judging the condition and improving the prognosis for patients with CAD.

The Correlation of MTHFR SNPs, Homocysteine, and Conventional Risk Predictors with Coronary Artery Disease

“…The regression analysis also maintained significance of disease with family history (p < 0.001, OR 1.341) but not with diabetes mellitus. Elevated homocysteine level is novel, independent risk factor of atherosclerotic vascular disease affecting many vascular beds such as peripheral, carotid and coronary vasculature, [2,17,22,35] the higher homocysteine levels being positively related to fatal outcomes [36]. The current study was consistent with previous literature, as both analyses maintained statistical significance of homocysteine with CAD.…”

Predictive Significance of High-Sensitivity C-Reactive Protein Combined with Homocysteine for Coronary Heart Disease in Patients with Anxiety Disorders

“…Recent studies have shown that elevated Hcy can promote lipid deposition in foam cells and accelerate the progression of atherosclerosis [ 46 ]. Clinical studies have found that the plasma expression of Hcy is elevated in CHD [ 47 , 48 ] and is related to coronary artery stenosis degree [ 49 ]. Therefore, Hcy can predict major adverse cardiovascular events and has important clinical significance in determining the condition and prognosis of CHD patients [ 47 ].…”

“…Clinical studies have found that the plasma expression of Hcy is elevated in CHD [ 47 , 48 ] and is related to coronary artery stenosis degree [ 49 ]. Therefore, Hcy can predict major adverse cardiovascular events and has important clinical significance in determining the condition and prognosis of CHD patients [ 47 ]. However, there are few studies on the changes in peripheral blood levels of Hcy in patients with anxiety disorders, and the results are inconsistent.…”

Biomarkers of Neutrophil Activation in Patients with Symptomatic Chronic Peripheral Artery Disease Predict Worse Cardiovascular Outcome

“…Conversely, individuals with genetic polymorphisms of MPO are at an increased risk of CAD [ 20 ]. Circulating levels of MPO are associated with both the presence [ 21 ] and severity [ 22 , 23 ] of CAD on angiography. Moreover, both in patients presenting to an emergency department with chest pain [ 24 ] and those with established CAD diagnosis [ 23 ], MPO circulating levels are predictive of adverse outcomes.…”