Plasma myeloperoxidase concentration predicts the presence and severity of coronary disease in patients with chest pain and negative troponin-T

• Published in: Coronary artery disease Vol. 22; no. 8; pp. 553 - 558
• Main Authors: Rebeiz, Abdallah G, Tamim, Hani M, Sleiman, Rima M, Abchee, Antoine G, Ibrahim, Zeina, Khoury, Maurice Y, Youhanna, Sonia, Skouri, Hadi N, Alam, Samir E
• Format: Journal Article
• Language: English
• Published: England Lippincott Williams & Wilkins, Inc 01-12-2011
• Subjects: Aged; Angina Pectoris - blood; Angina Pectoris - diagnosis; Angina Pectoris - etiology; Angina Pectoris - therapy; Angioplasty, Balloon, Coronary; Biomarkers - blood; Chi-Square Distribution; Coronary Angiography; Coronary Artery Bypass; Coronary Stenosis - blood; Coronary Stenosis - complications; Coronary Stenosis - diagnosis; Coronary Stenosis - therapy; Female; Humans; Lebanon; Male; Middle Aged; Odds Ratio; Peroxidase - blood; Predictive Value of Tests; Retrospective Studies; Risk Assessment; Risk Factors; Severity of Illness Index; Troponin T - blood; Lebanon
• ISSN: 0954-6928; 1473-5830
• DOI: 10.1097/MCA.0b013e32834c5e98

BACKGROUNDA non-negligible proportion of patients with chest pain with negative cardiac troponin may harbor a disrupted coronary plaque. A marker of plaque rupture upstream from myocardial necrosis may help identify high-risk patients among this patient population. The purpose of this study was to investigate the correlation of plasma myeloperoxidase (MPO) concentration and angiographic coronary disease among patients with suspected troponin-negative coronary syndromes.
PATIENTS AND METHODSPatients presenting with chest pain and negative cardiac troponin-T concentration and undergoing coronary angiography were enrolled in our study. Plasma MPO concentration was measured using a single blood sample collected prior to cardiac catheterization. The primary angiographic endpoint was the presence of at least one coronary stenosis causing a 70% or more diameter reduction; secondary endpoints were number of diseased vessels, presence of coronary thrombus, and lesion ulceration. The main clinical endpoint was coronary revascularization.
RESULTSThree hundred and eighty-nine patients were enrolled. Presence of coronary stenosis causing a 70% or more diameter reduction increased with increasing quartiles of myeloperoxidase concentration (P<0.0001), as did the presence of coronary thrombus (P<0.0001) and plaque ulceration (P<0.0001). The need for percutaneous coronary revascularization also increased with increasing quartiles of systemic myeloperoxidase levels (P<0.0001). Coronary surgical revascularization did not differ among myeloperoxidase quartiles.
CONCLUSIONAmong patients with chest pain without troponin elevation, a single measurement of plasma MPO concentration can help identify patients with a higher risk of having significant coronary stenoses and high-risk angiographic features.