Level and significance of plasma myeloperoxidase and the neutrophil to lymphocyte ratio in patients with coronary artery disease

Abstract

Inflammation plays a pivotal role in the etiology of coronary artery disease (CAD). Myeloperoxidase (MPO) is a potent inflammatory factor and a critical modulator of coronary inflammation and oxidative stress. The goal of this study was to determine the impact of the plasma MPO (pMPO) level and neutrophil/lymphocyte ratio on the clinical characteristics and outcomes of patients with CAD. Blood samples were collected from 210 patients with underlying chest pain or recent myocardial infarction (MI) prior to coronary angiography in order to measure pMPO levels. The pMPO levels and neutrophil/lymphocyte ratio were correlated with clinical characteristics and outcomes following catheterization. The pMPO level and neutrophil/lymphocyte ratio were higher in patients with recent MI than in patients with CAD (coronary occlusion ≥50%) or without CAD (coronary occlusion <50%). Patients with ST segment elevated MI (STEMI) had a higher neutrophil/lymphocyte ratio relative to patients with non-STEMI. The pMPO level was identified to correlate with the neutrophil/lymphocyte ratio and the need for coronary artery reperfusion by coronary artery bypass surgery or percutaneous coronary intervention. Patients who were taking aspirin had lower pMPO levels and neutrophil/lymphocyte ratio compared with those who were not taking aspirin. The plasma neutrophil/lymphocyte ratio was negatively associated with the left ventricular ejection fraction at baseline and the 30-day follow-up, whereas pMPO showed no correlation. Multivariate analysis indicated that the pMPO level was positively associated with MI, the neutrophil/lymphocyte ratio and coronary intervention. The preoperative use of aspirin was associated with a lower pMPO level and neutrophil/lymphocyte ratio. In conclusion, pMPO is positively associated with MI, the neutrophil/lymphocyte ratio and coronary intervention. The preoperative use of aspirin is associated with a lower pMPO level and neutrophil/lymphocyte ratio. pMPO may serve as a predictor of coronary intervention and as a potential therapeutic target for the reduction of inflammation in patients with CAD.

Association of interleukin-6 gene polymorphism with coronary artery disease: an updated systematic review and cumulative meta-analysis

“…Inflammatory response plays a key role in the development stage of CAD [47][48][49]. IL-6 is one of the multifunctional cytokines.…”

Hematological predictors and clinical outcomes in cardiac surgery

“…It was also found in the present study that NLR is a better predictor (4.8 times) than the other hemogram parameters in the prediction of CAE. The superiority of NLR, compared to leukocytes, neutrophils, and lymphocytes, as an independent mortality factor in cardiovascular surgery has been reported [34,36]. However, to the best of our knowledge, there exists no study examining NLR along with other hemogram parameters, such as Hb, RDW, MPV, and PLR, in the prediction of heart surgery outcomes.…”

“…Neutrophil and relative lymphopenia are considered as independent predictors for heart failure, and NLR is used as a mortality marker following cardiac disease [11,32,33]. In the present study, the cutoff value for NLR was set as 2.81 based on the ROC value used in the cardiac study performed in our hospital [11]; in other studies, it has been reported as 2.72 and 3 [34,35]. NLR has been considered as a good marker in the prediction of the outcomes in cardiac diseases [31][32][33][34][35][36].…”

“…In the present study, the cutoff value for NLR was set as 2.81 based on the ROC value used in the cardiac study performed in our hospital [11]; in other studies, it has been reported as 2.72 and 3 [34,35]. NLR has been considered as a good marker in the prediction of the outcomes in cardiac diseases [31][32][33][34][35][36]. Similarly, high NLR value was found to be an independent predictor of CAE development based on both univariate and multivariate analyses.…”

Pharmacokinetics and Disposition of the Thiouracil Derivative PF-06282999, an Orally Bioavailable, Irreversible Inactivator of Myeloperoxidase Enzyme, Across Animals and Humans

“…MPO has recently emerged as a critical modulator of inflammatory conditions including rheumatoid arthritis (Odobasic et al, 2014), chronic obstructive pulmonary disease (Churg et al, 2012), acute kidney injury (Odobasic et al, 2007), Parkinson's disease (Choi et al, 2005), and cardiovascular disease (Mayyas et al, 2014). High concentrations of MPO have been detected in atherosclerotic plaques (Hazell et al, 1996) and elevated MPO levels are associated with risk of cardiovascular disease in otherwise healthy individuals (Meuwese et al, 2007).…”