Prognostic significance of myeloperoxidase in prediction in-hospital mortality in patients with ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention

Abstract

Background: The predictive value of myeloperoxidase (MPO) with respect to in- hospital mortality in ST-segment elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention (PCI) is unknown. The aim of the present study was to investigate MPO as a predictor of in-hospital mortality in STEMI patients treated by primary PCI. Methods: Study population consisted of 189 STEMI patients underwent primary PCI. Plasma MPO level was measured 24h after symptom onset using chemilu- minescent microparticle immunoassay (Abbott Diagnostics, Germany). The Re- ceiver Operating Characteristic analysis was performed to identify the most useful MPO cut-off level for the prediction of in-hospital mortality. The patients were di- vided into two groups according to the cut-off MPO level. Results: The incidence of in-hospital mortality was 5.8% (11/189 patients). It was significantly higher in those with high MPO (≥840 pmol/L) (13.8%, 9/65 patients) than in those with low MPO (<840 pmol/L) (1.6%, 2/124 patients) (p=0.001). Patients with a high MPO had significantly more frequent anterior wall infarc- tion (p<0.001), higher Killip class at admission (p=0.013), lower left ventricular ejection fraction (LVEF) (p=0.011) and higher B-type natriuretic peptide (BNP) (p=0.029) than patients with low MPO. Multiple logistic regression analysis re- vealed that the independent predictors of in-hospital mortality were MPO (OR 3.88, 95%CI 1.13–13.34, p=0.031), BNP (OR 4.40, 95%CI 1.11–17.37, p=0.034), lower LVEF (OR 0,88, 95%CI 0.80–0.97, p=0.009), estimated glomerular filtration rate (OR 0,93, 95%CI 0.88–0.99, p=0.035), Killip class at admission (OR 10.76, 95%CI 1.23–94.01, p=0.032). Conclusion: Plasma MPO level independently predicts in-hospital mortality in STEMI patients treated by primary PCI.