Prognostic Value of Myeloperoxidase in Patients With Chest Pain

Abstract

To study the risk factors for febrile morbidity associated with hysterectomy, the authors reviewed the medical records of women who underwent hysterectomy at their institution between January and September 1997. Only women with benign conditions were included. Possible risk factors for postoperative febrile morbidity, including demographic, reproductive, clinical, and operative characteristics of patients, were identified and subjected to multivariate logistic regression analysis. Sixty percent (n ϭ 408) of the procedures were abdominal hysterectomy, 13% (n ϭ 90) were laparoscopic-assisted vaginal hysterectomy, and 27% (n ϭ 188) were vaginal hysterectomy. The women who had abdominal procedures were more likely to have private health insurance, to be nulliparous, and to have a body mass index above 30 kg/m 2 than those who had vaginal hysterectomy. Also, more women who had abdominal or laparoscopically assisted vaginal hysterectomy were less than 50 years of age. Differences in clinical characteristics included higher rates of estimated blood loss in the abdominal and laparoscopic-assisted vaginal hysterectomy groups and longer operative times in the laparoscopic-assisted vaginal hysterectomy procedures. In all, 14% (n ϭ 96) of the 686 patients developed a postoperative fever. The incidence was significantly higher in the abdominal group compared with the vaginal and laparoscopically assisted vaginal hysterectomy (18% vs. 9% and 8%, respectively). Fifty percent of all patients were given no preoperative antibiotics. Forty-five percent of the women who underwent abdominal hysterectomy received preoperative antibiotics compared with 53% and 59% of those who had vaginal or laparoscopically assisted vaginal hysterectomy, respectively. Nineteen percent of all patients received no prophylactic antibiotic therapy. Multivariate logistic regression analysis of possible risk factors for febrile morbidity, after adjustment for age, insurance, parity, and body mass index, found that surgical approach and estimated blood loss were predictive of postoperative febrile morbidity. Abdominal hysterectomy had an odds ratio for development of postoperative fever of 2.5 (95% confidence interval, 1.3-4.9) compared with vaginal hysterectomy. The comparable odds ratio for blood loss greater than 750 mL was 3.7 (95% confidence interval, 1.9-7.2). ABSTRACTThe authors used a running mass technique using looped N. 1 polydioxanone suture to close the abdominal wall in a series of 149 high-risk gynecologic surgery patients who were either obese or had a diagnosis of gynecologic cancer. A midline vertical incision was used in 146 cases and transverse incision in 3. The first bite was draw through the loop. ABSTRACTDanish women who were scheduled to undergo hysterectomy for benign disease were invited to participate in a randomized, controlled trial of total versus subtotal hysterectomy. Outcome measures included urinary incontinence, postoperative complications, quality of life, constipation, prolapse of the vaginal top/cervical stump, satisfac...

Temporal shifts in clinical presentation and underlying mechanisms of atherosclerotic disease

“…Circulating biomarkers that add to the prediction of the progression of atherosclerotic disease and inform regarding the effects of novel therapies still comprise an unmet need 75 76 77 The concept that acute atherosclerotic events commonly complicate highly inflammatory and proteolytic plaques has driven many biomarker discovery programs. Many proposed biomarkers with predictive value for MI such as myeloperoxidase 78 , high sensitive C reactive protein, and soluble ICAM 79 arise from the idea that vascular inflammation participates pivotally in the pathogenesis of cardiovascular events. While this concept has served the community well, and derives support form a large body of consistent studies, this formulation may apply less to a growing group of patients with ischemic heart disease receiving current standard of care treatments.…”

Myeloperoxidase in Chronic Kidney Disease

“…Furthermore, high levels of MPO-mediated endothelial dysfunction may be an important mechanistic link between oxidation, inflammation, and cardiovascular disease (CVD) [6]. An elevated level of plasma MPO served as independent predictor of increased risk of myocardial infarction [7]. However, the role of MPO in chronic kidney disease (CKD) is poorly understood, and not much data is available regarding the variations of this enzyme in these patients.…”

Myeloperoxidase-derived oxidants damage artery wall proteins in an animal model of chronic kidney disease–accelerated atherosclerosis

“…MPO co-localizes with macrophages in human atherosclerotic lesions (33) and MPO oxidation products are present in human atherosclerotic lesions demonstrated by immunohistochemistry and quantification using mass spectrometry (28,(33)(34)(35)(36). More importantly, elevated plasma MPO levels predict the risk of cardiovascular events and mortality in patients with unstable angina, chest pain (37), acute coronary syndrome, or peripheral arterial disease (37)(38)(39)(40). Systemic levels of 3-nitrotyrosine have also been found to be higher among patients with CVD compared to those with healthy arteries (41)(42)(43).…”