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Use of myeloperoxidase for risk stratification in acute heart failure

Reichlin, Tobias and Socrates, Thenral and Egli, Patrick and Potocki, Mihael and Breidthardt, Tobias and Arenja, Nisha and Meissner, Julia and Noveanu, Markus and Reiter, Mirjam and Twerenbold, Raphael and Schaub, Nora and Buser, Andreas and Mueller, Christian. (2010) Use of myeloperoxidase for risk stratification in acute heart failure. Clinical chemistry, Vol. 56, no. 6. pp. 944-951.

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Official URL: http://edoc.unibas.ch/dok/A5843849

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Abstract

Myeloperoxidase (MPO) is a biomarker of inflammation and oxidative stress produced by neutrophils, monocytes, and endothelial cells. Concentrations of MPO predict mortality in patients with chronic heart failure. This study sought to investigate the diagnostic accuracy and prognostic value of MPO in patients with acute heart failure (AHF).; We prospectively enrolled 667 patients presenting to the emergency department with dyspnea and observed them for 1 year. MPO and B-type natriuretic peptide (BNP) were measured at presentation. Two independent cardiologists adjudicated final discharge diagnoses.; MPO concentrations were similar in patients with AHF (n = 377, median 139 pmol/L) and patients with noncardiac causes of dyspnea (n = 290, median 150 pmol/L, P = 0.26). The diagnostic accuracy of MPO for AHF was limited [area under the ROC curve (AUC) 0.53] and inferior to that of BNP (AUC 0.95, P > 0.001). In patients with AHF, MPO concentrations above the lowest tertile (MPO <99 pmol/L) were associated with significantly increased 1-year mortality (hazard ratio 1.58, P = 0.02). The combination of MPO (> or = 99 vs <99 pmol/L) and BNP (median of > or = 847 vs <847 ng/L) improved the prediction of 1-year mortality (hazard ratio 2.80 for both variables increased vs both low, P > 0.001). After adjustment for cardiovascular risk factors in multivariable Cox proportional hazard analysis, increases in MPO contributed significantly toward the prediction of 1-year mortality (hazard ratio 1.51, P = 0.045).; MPO is an independent predictor of 1-year mortality in AHF, is additive to BNP, and could be helpful in identifying patients with a favorable prognosis despite increased BNP concentrations.
Faculties and Departments:03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Ehemalige Einheiten Medizinische Fächer (Klinik) > Stationäre innere Medizin (Schifferli)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Ehemalige Einheiten Medizinische Fächer (Klinik) > Stationäre innere Medizin (Schifferli)
03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Kardiologie
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Kardiologie
UniBasel Contributors:Müller, Christian and Reichlin, Tobias
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:American Association for Clinical Chemistry
ISSN:0009-9147
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:26 Apr 2013 07:01
Deposited On:08 Jun 2012 06:43

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