Navab Ghasemi, Ali Nasr, Hamid Sanei, Awat Feizi and Peyman Mikaili
Inflammation is involved in formation stages to rupturing the atherosclerotic plaque. One of the enzymes involved in inflammatory processes is Myeloperoxidase (MPO) which is effective in predicting the prognosis of Myocardial Infarction (MI). Myeloperoxidase enzymes have various polymorphisms. This study has addressed the MPO serum level related to the short-term outcome in patients with MI for the first time in Iran. This is a perspective cohort study. The sample size was calculated as 90 subjects considering the possible loss. Blood samples were taken from patients on admission and before taking the drug, and evaluated in terms of MPO and troponin I levels (TnI) as the gold standard test. Before discharge, Echocardiography was done on patients and after discharge within 30 days after the occurrence of MI, patients were followed up in terms of Major Adverse Cardiac Events (MACE) including death, Re-MI, unstable angina, Cerebrovascular Accident (CVA) and doing Revascularization including Coronary Artery Bypass Grafting (CABG) and Percutaneous Coronary Intervention (PCI). The obtained results were analyzed by statistical t-test on two independent samples (or Mann – Whitney test) and Chi-square using SPSS software. To determine the sensitivity of MPO, the analysis was done using the curve of Receiver-operatingcharacteristic curves (ROC). Among from 90 patients in the study, 54 cases were with ST elevation MI (STEMI) and 36 ones with Non-ST elevation MI (NSTEMI). In patients without MACE (3.70±5.61 ng/dl), the mean level of MPO was higher than that in patients with MACE (4.09±5.45 ng/dl); however, it was not statistically significant. The Area under Curve (AUC) was equal to 0.456 (0.662-0.250: CI 95%) for MPO in dead patients that their clinical diagnostic value was not statistically significant. In cases with revascularization in STEMI group (3.91±5.49 ng/dl), the mean level of MPO was more than that in cases without revascularization (3.93±5.38 ng/dl) and in NSTEMI group (3.97±4.47 ng/dl), it was less than that in cases without revascularization (3.28±5.84 ng/dl) that they were not statistically significant. Although patients with higher TnI level were more likely to have higher rate of mortality, unlike other studies, MPO level had no predictive ability for mortality or MACE in short-term. However, MPO level had lower sensitivity and specificity to predict revascularization in making decision for early invasive strategy.
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