Diagnostic efficacy of myeloperoxidase to identify acute coronary syndrome in subjects with chest pain. (June 2013)

• Record Type: Journal Article
• Authors: Granér, Marit; Tikkanen, Emmi; Rimpilä, Olga; Tikkanen, Helena; Ripatti, Samuli; Lokki, Marja-Liisa; Nieminen, Markku S.; Taskinen, Marja-Riitta; Sinisalo, Juha
• Is Part Of: Annals of medicine. Volume 45:Number 4(2013)
• Page Start: 322
• Page End: 327
• Publication Date: 2013-06
• Subjects: Medicine -- Periodicals; 610
• DOI: 10.3109/07853890.2013.783996
• Languages: English
• ISSNs: 0785-3890

Abstract

<abstract> <title>Abstract</title> <p> <italic>Background.</italic> Early diagnosis of acute coronary syndrome (ACS) is frequently a challenging task.</p> <p> <italic>Aims.</italic> To assess the role of novel biomarkers to identify ACS.</p> <p> <italic>Methods.</italic> Concentrations of lipids, lipoproteins, oxidized LDL (oxLDL), high-sensitivity C-reactive protein (hsCRP), paraoxonase-1 (PON1), secretory phospholipase A2 (sPLA2), and myeloperoxidase (MPO) were measured in 703 patients (mean age 65.5 ± 11.2 years; 422 men, 281 women) without diabetes mellitus assigned to coronary angiogram. The subjects were divided into three groups: ACS (<italic>n</italic> = 242), stable angina pectoris (SAP) (<italic>n</italic> = 242), and normal coronary artery (NCA) (<italic>n</italic> = 219).</p> <p> <italic>Results.</italic> HDL-cholesterol (HDL-C) (<italic>P</italic> < 0.001) and apolipoproteinA-I concentrations (<italic>P</italic> < 0.0001) were lowest in subjects with ACS. LDL-C (<italic>P = </italic> 0.008) and non-HDL (<italic>P</italic> < 0.0001) were higher in the ACS group than in the SAP group. Leukocyte count (<italic>P</italic> < 0.0001), oxLDL (<italic>P </italic>< 0.05), hsCRP (<italic>P</italic> < 0.001), sPLA2 (<italic>P</italic> < 0.05), and MPO (<italic>P </italic>< 0.0001) were highest in the ACS group. In multivariate models, comprising all biomarkers, elevated level of MPO had the best discriminatory power to identify patients with ACS. Receiver-operating characteristic curve with and without MPO comparison differed significantly (<italic>P = </italic> 0.03 for both ACS versus NCA and ACS versus SAP).</p> <p> <italic>Conclusion.</italic> Our study shows that ACS associates with low HDL-C and biomarkers of oxidative stress and inflammation. The addition of MPO in biomarker panels might improve diagnostic accuracy for ACS.</p> </abstract>