The Diagnostic and Prognostic Performance of Myeloperoxidase Plasma Levels as Compared to Sensitive Troponins in Patients Admitted with Acute Onset Chest Pain.
Circ Cardiovasc Genet. 2012 Aug 24;
Authors: Rudolph V, Keller T, Schulz A, Ojeda F, Rudolph TK, Tzikas S, Bickel C, Meinertz T, Münzel T, Blankenberg S, Baldus S
Abstract
BACKGROUND: -Activation of leukocytes with release of myeloperoxidase (MPO) has been linked to acute coronary disease. To date studies investigating the diagnostic and prognostic performance of circulating MPO in patients with chest pain (CP) are mainly retrospective, of low size and all lack a cut-off value for MPO. Herein we prospectively assess the diagnostic and prognostic properties of MPO compared to sensitive troponin I (sTNI) in patients admitted to the emergency room with CP. METHODS AND RESULTS: -1818 consecutive patients (mean age 61.4±13.5 y, 33.6% female) admitted for CP underwent determination of MPO, sTnI and BNP plasma levels at admission and 3 h and 6 h thereafter. A cut off for MPO was defined in 5000 population-based subjects. Baseline MPO levels were elevated in patients with acute myocardial infarction compared to patients with non-coronary chest pain. For all time-points accuracy of MPO was inferior to sTNI for predicting AMI. The sensitivity of MPO to diagnose AMI at presentation was 73.5% compared to 90.7% for sTNI and the specificity of MPO was 45.5% as opposed to 90.2%. BNP levels also failed to demonstrate independent diagnostic information. Both, MPO and BNP were predictive for increased risk of adverse events at 30 days and 6 months, whereas their predictive value was weakened after covariate adjustment. CONCLUSIONS: -The data demonstrate that MPO and BNP fail to provide incremental information for patients with acute onset chest pain when added to sensitive troponin. However there is a potential value for both biomarkers as prognostic markers.
PMID: 22923422 [PubMed - as supplied by publisher]