Serial Analyses of C‐Reactive Protein and Myeloperoxidase in Acute Coronary Syndrome

Abstract

Background: C-reactive protein (CRP) and myeloperoxidase (MPO) are involved in the pathogenesis of atherosclerosis, mainly during periods of instabilization. This study aims to test the hypothesis that patients with acute coronary syndrome (ACS) maintain a persistent inflammatory state, and that this is associated with long-term mortality. Hypothesis: We hypothesized that serum C-reactive protein and myeloperoxidase collected at the index event and later, could add to the prognostic information in patients with ACS. Methods: In a prospective cohort of 115 consecutive patients with ACS, myeloperoxidase and C-reactive protein were measured at admission and 2 y later. Patients were followed-up for the occurrence of cardiac death and other major cardiac events. Results: Levels of CRP decreased from 26±34 mg/L in the acute phase to 6±8 mg/L in the chronic phase (p<0.001), and MPO levels decreased from 86±43 pM to 27±32 pM (p<0.001). After 29±12 mo, 27% patients died, 39% had new episode of ACS, and 30% underwent revascularization procedures. Initial CRP levels above 10 mg/L were associated with higher long-term mortality (hazard ratio [HR]

Lack of association between plasma myeloperoxidase levels and angiographic severity of coronary artery disease in patients with acute coronary syndrome

“…MPO has recently been shown to progress from stable coronary artery disease (CAD) to non-ST elevation ACS, reaching the highest levels in patients with ST-elevation acute myocardial infarction (MI) [18]. Moreover, after ACS, although plasma MPO levels decrease over time, they might remain elevated for up to 2 years of follow-up [19].…”

Myeloperoxidase: New Roles for an Old Molecule

“…MPO levels before thrombolysis were significantly lower in patients with successful reperfusion. Borges et al (43) found that although the plasma MPO level decreases over time after ACS, it might remain elevated for up to 2 years of follow-up. Chang et al (44) found that high serum MPO independently predicts the risk of 30-day composite occurrence of major adverse clinical events (reinfarction, repeat PCI, Killip classification ≥3) in 128 patients with ST-segment elevation AMI undergoing primary percutaneous coronary intervention.…”

Response to Incremental Predictive Value of Red Cell Distribution Width for 12‐Month Clinical Outcome After Acute Myocardial Infarction

“…Preprocedural serum inflammatory markers such as C-reactive protein (CRP) level may be associated with early complications 3 and long-term prognosis 4 in patients undergoing percutaneous coronary intervention. 5 Inflammatory markers are considered a major risk factor predisposing to cardiovascular morbidity and mortality. 6 Recently, a number of studies have reported that elevated RDW levels are associated with poor prognosis in the setting of stable angina, acute coronary syndrome, coronary bypass surgery, heart failure, stroke, peripheral arterial disease, older age, and in patients with or without coronary artery disease (CAD).…”