Background: Research has shown that high-sensitivity C-reactive protein (hs-CRP) is a major inflammatory marker for prediction of acute coronary syndrome (ACS). Myeloperoxidase (MPO) also plays an important role in atherosclerosis initiation and development. In present study, the major adverse cardiovascular events (MACEs) of patients with coronary heart disease (CHD) were investigated. Methods: MPO, hs-CRP and ACS-related risk factors from 201 ACS (78 AMI and 123 UAP) and 210 non-ACS (84 SAP and 126 non-CHD) patients confirmed by coronary angiography were detected, and the data were analyzed with receiver operating characteristic (ROC) curve and Spearman’s correlation coefficients. MACEs of 285 CHD patients were investigated during the 4-year period follow-up from March 2010 to May 2014. Results: The areas under ROC curve for diagnosing ACS were 0.888 (95% CI 0.843 - 0.933) for MPO, and 0.862 (95% CI 0.815-0.910) for hs-CRP, respectively. There were significantly correlations between MPO and hs-CRP in both ACS and non-ACS groups. Regarding to ACS patients, both MPO and hs-CRP were positively correlated with BMI, TC, TG, LDL-C and Hcy. Prospective study demonstrated that the incidences of MACEs associated significantly with elevated MPO baseline level (yes vs no, OR 7.383, 95% CI 4.095 - 13.309) and high hs-CRP baseline level (yes vs no, OR 4.186, 95% CI 2.469 - 7.097) in CHD patients. Conclusions: The present study provides the epidemiological evidence that elevated baseline MPO and hs-CRP levels are both valuable predictors of MACEs in CHD patients. MPO and hs-CRP would prompt the progression of atherosclerosis and development from SAP to ACS.
References
[1]
Hansson, G.K. (2005) Inflammation, Atherosclerosis, and Coronary Artery Disease. New England Journal of Medicine, 352, 1685-1695. http://dx.doi.org/10.1056/NEJMra043430
[2]
Dominguez-Rodriguez, A., Abreu-Gonzalez, P. and Kaski, J.C. (2009) Inflammatory Systemic Biomarkers in Setting Acute Coronary Syndromes—Effects of the Diurnal Variation. Current Drug Targets, 10, 1001-1008. http://dx.doi.org/10.2174/138945009789577963
[3]
Libby, P., Okamoto, Y., Rocha, V.Z. and Folco, E. (2010) Inflammation in Atherosclerosis: Transition from Theory to Practice. Circulation Journal, 74, 213-220. http://dx.doi.org/10.1253/circj.CJ-09-0706
[4]
Karakas, M. and Koenig, W. (2009) CRP in Cardiovascular Disease. Herz, 34, 607-613. http://dx.doi.org/10.1007/s00059-009-3305-7
[5]
Schwarzer, R., Schnell-Inderst, P., Grabein, K., Gohler, A., Stollenwerk, B., Grandi, N., et al. (2009) Prognostic Value and Clinical Effectiveness of High Sensitivity C-Reactive Protein as a Marker in Primary Prevention of Major Cardiac Events. Zeitschrift für Evidenz, Fortbildung und Qualitat im Gesundheitswesen, 103, 319-329. http://dx.doi.org/10.1016/j.zefq.2009.05.020
[6]
Cheng, J.M., Oemrawsingh, R.M., Garcia-Garcia, H.M., Akkerhuis, K.M., Kardys, I., de Boer, S.P., et al. (2014) Relation of C-Reactive Protein to Coronary Plaque Characteristics on Grayscale, Radiofrequency Intravascular Ultrasound, and Cardiovascular Outcome in Patients with Acute Coronary Syndrome or Stable Angina Pectoris (from the ATHEROREMO-IVUS Study). American Journal of Cardiology, 114, 1497-1503. http://dx.doi.org/10.1016/j.amjcard.2014.08.013
[7]
Wang, X.H., Liu, S.Q., Wang, Y.L. and Jin, Y. (2014) Correlation of Serum High-Sensitivity C-Reactive Protein and Interleukin-6 in Patients with Acute Coronary Syndrome. Genetics and Molecular Research, 13, 4260-4266. http://dx.doi.org/10.4238/2014.June.9.11
[8]
Cavusoglu, E., Ruwende, C., Eng, C., Chopra, V., Yanamadala, S., Clark, L.T., et al. (2007) Usefulness of Baseline Plasma Myeloperoxidase Levels as an Independent Predictor of Myocardial Infarction at Two Years in Patients Presenting with Acute Coronary Syndrome. American Journal of Cardiology, 99, 1364-1368. http://dx.doi.org/10.1016/j.amjcard.2006.12.060
[9]
Tang, W.H., Wu, Y., Nicholls, S.J. and Hazen, S.L. (2011) Plasma Myeloperoxidase Predicts Incident Cardiovascular Risks in Stable Patients Undergoing Medical Management for Coronary Artery Disease. Clinical Chemistry, 57, 33-39. http://dx.doi.org/10.1373/clinchem.2010.152827
[10]
Ferrante, G., Nakano, M., Prati, F., Niccoli, G., Mallus, M.T., Ramazzotti, V., et al. (2010) High Levels of Systemic Myeloperoxidase Are Associated with Coronary Plaque Erosion in Patients with Acute Coronary Syndromes: A Clinicopathological Study. Circulation, 122, 2505-2513. http://dx.doi.org/10.1161/CIRCULATIONAHA.110.955302
[11]
Yunoki, K., Naruko, T., Inaba, M., Inoue, T., Nakagawa, M., Sugioka, K., et al. (2013) Gender-Specific Correlation between Plasma Myeloperoxidase Levels and Serum High-Density Lipoprotein-Associated Paraoxonase-1 Levels in Patients with Stable and Unstable Coronary Artery Disease. Atherosclerosis, 231, 308-314. http://dx.doi.org/10.1016/j.atherosclerosis.2013.08.037
[12]
Liu, C., Xie, G., Huang, W., Yang, Y., Li, P. and Tu, Z. (2012) Elevated Serum Myeloperoxidase Activities Are Significantly Associated with the Prevalence of ACS and High LDL-C Levels in CHD Patients. Journal of Atherosclerosis and Thrombosis, 19, 435-443. http://dx.doi.org/10.5551/jat.9704
[13]
Packard, R.R. and Libby, P. (2008) Inflammation in Atherosclerosis: From Vascular Biology to Biomarker Discovery and Risk Prediction. Clinical Chemistry, 54, 24-38. http://dx.doi.org/10.1373/clinchem.2007.097360
[14]
Rodondi, N., Marques-Vidal, P., Butler, J., Sutton-Tyrrell, K., Cornuz, J., Satterfield, S., et al. (2010) Markers of Atherosclerosis and Inflammation for Prediction of Coronary Heart Disease in Older Adults. American Journal of Epidemiology, 171, 540-549. http://dx.doi.org/10.1093/aje/kwp428
[15]
Ougrinovskaia, A., Thompson, R.S. and Myerscough, M.R. (2010) An ODE Model of Early Stages of Atherosclerosis: Mechanisms of the Inflammatory Response. Bulletin of Mathematical Biology, 72, 1534-1561. http://dx.doi.org/10.1007/s11538-010-9509-4
[16]
Libby, P. (2002) Inflammation in Atherosclerosis. Nature, 420, 868-874. http://dx.doi.org/10.1038/nature01323
[17]
Calabrò, P., Golia, E. and Yeh, E.T. (2009) CRP and the Risk of Atherosclerotic Events. Seminars in Immunopathology, 31, 79-94. http://dx.doi.org/10.1007/s00281-009-0149-4
[18]
Arima, H., Kubo, M., Yonemoto, K., Doi, Y., Ninomiya, T., Tanizaki, Y., et al. (2008) High-Sensitivity C-Reactive Protein and Coronary Heart Disease in a General Population of Japanese: The Hisayama Study. Arteriosclerosis, Thrombosis, and Vascular Biology, 28, 1385-1391. http://dx.doi.org/10.1161/ATVBAHA.107.157164
[19]
Otake, H., Shite, J., Shinke, T., Watanabe, S., Tanino, Y., Ogasawara, D., et al. (2008) Relation between Plasma Adiponectin, High-Sensitivity C-Reactive Protein, and Coronary Plaque Components in Patients with Acute Coronary Syndrome. American Journal of Cardiology, 101, 1-7. http://dx.doi.org/10.1016/j.amjcard.2007.07.041
[20]
He, L.P., Tang, X.Y., Ling, W.H., Chen, W.Q. and Chen, Y.M. (2010) Early C-Reactive Protein in the Prediction of Long-Term Outcomes after Acute Coronary Syndromes: A Meta-Analysis of Longitudinal Studies. Heart, 96, 339-346. http://dx.doi.org/10.1136/hrt.2009.174912
[21]
Liang, J., Zheng, Z., Wang, M., Han, L., Zheng, Z., Peng, J., et al. (2009) Myeloperoxidase (MPO) and Interleukin-17 (IL-17) Plasma Levels Are Increased in Patients with Acute Coronary Syndromes. Journal of International Medical Research, 37, 862-866. http://dx.doi.org/10.1177/147323000903700331
[22]
Roman, R.M., Camargo, P.V., Borges, F.K., Rossini, A.P. and Polanczyk, C.A. (2010) Prognostic Value of Myeloperoxidase in Coronary Artery Disease: Comparison of Unstable and Stable Angina Patients. Coronary Artery Disease, 21, 129-136. http://dx.doi.org/10.1097/MCA.0b013e328333f50d
[23]
Nakou, E.S., Liberopoulos, E.N., Milionis, H.J. and Elisaf, M.S. (2008) The Role of C-Reactive Protein in Atherosclerotic Cardiovascular Disease: An Overview. Current Vascular Pharmacology, 6, 258-270. http://dx.doi.org/10.2174/157016108785909733
[24]
Ferri, C., Croce, G., Cofini, V., De Berardinis, G., Grassi, D., Casale, R., et al. (2007) C-Reactive Protein: Interaction with the Vascular Endothelium and Possible Role in Human Atherosclerosis. Current Pharmaceutical Design, 13, 1631-1645. http://dx.doi.org/10.2174/138161207780831301
[25]
Zhang, R., Brennan, M.L., Shen, Z., MacPherson, J.C., Schmitt, D., Molenda, C.E., et al. (2002) Myeloperoxidase Functions as a Major Enzymatic Catalyst for Initiation of Lipid Peroxidation at Sites of Inflammation. Journal of Biological Chemistry, 277, 46116-46122. http://dx.doi.org/10.1074/jbc.M209124200
[26]
Wang, Z., Nicholls, S.J., Rodriguez, E.R., Kummu, O., Horkko, S., Barnard, J., et al. (2007) Protein Carbamylation Links Inflammation, Smoking, Uremia and Atherogenesis. Nature Medicine, 13, 1176-1184. http://dx.doi.org/10.1038/nm1637
[27]
Zheng, L., Nukuna, B., Brennan, M.L., Sun, M., Goormastic, M., Settle, M., et al. (2004) Apolipoprotein A-I Is a Selective Target for Myeloperoxidase-Catalyzed Oxidation and Functional Impairment in Subjects with Cardiovascular Disease. Journal of Clinical Investigation, 114, 529-541. http://dx.doi.org/10.1172/JCI200421109
[28]
Heinecke, J.W. (2007) The Role of Myeloperoxidase in HDL Oxidation and Atherogenesis. Current Atherosclerosis Reports, 9, 249-251. http://dx.doi.org/10.1007/s11883-007-0027-2
[29]
Meuwese, M.C., Stroes, E.S., Hazen, S.L., van Miert, J.N., Kuivenhoven, J.A., Schaub, R.G., et al. (2007) Serum Myeloperoxidase Levels Are Associated with the Future Risk of Coronary Artery Disease in Apparently Healthy Individuals: The EPIC-Norfolk Prospective Population Study. Journal of the American College of Cardiology, 50, 159-165. http://dx.doi.org/10.1016/j.jacc.2007.03.033
