Document Detail


Serum myeloperoxidase level predicts reperfusion in patients with myocardial infarction receiving thrombolytic therapy.
MedLine Citation:
PMID:  19626395     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Polymorphonuclear leukocytes play a central role in all stages of the atherothrombotic inflammatory process. The atherothrombotic activity of polymorphonuclear leukocytes is exerted by mediators such as myeloperoxidase (MPO). Although the role of MPO has been studied with respect to the development of adverse cardiac events in acute coronary syndromes (ACS), the association of this molecule with effectiveness of reperfusion in patients receiving thrombolysis is not yet known. The study population consisted of a total of 158 patients with acute coronary syndromes. Final diagnosis was ST-segment elevation myocardial infarction in 86 patients, 80 of whom received thrombolysis. Blood samples were drawn at presentation of the patients and serum myeloperoxidase levels were measured. Reperfusion was defined in terms of electrocardiographic ST-segment resolution. The serum levels of MPO were found to be correlated with rates of in-hospital adverse events including death (P < 0.001), reinfarction (P < 0.001), recurrent ischemia (P < 0.001), arrhythmias (P < 0.001), clinical heart failure (P < 0.001), and cardiogenic shock (P < 0.001). There was a significant difference in serum MPO levels between subjects with three-vessel disease and two- or one-vessel disease (P < 0.001). Pre-lytic serum high-sensitivity C-reactive protein levels in patients with successful reperfusion were lower than in patients with failed reperfusion (P < 0.001). Analysis of patients with ST segment elevation myocardial infarction receiving thrombolytic therapy revealed that pre-lytic serum MPO levels in patients with successful reperfusion were significantly lower than those of patients with failed reperfusion (P < 0.001). In the present study, serum MPO levels were found to be a strong predictor of response to thrombolytic treatment in patients with ST-segment elevation myocardial infarction. Therefore the level of inflammatory activity in acute coronary syndromes seems to influence the effectiveness of fibrinolysis.
Authors:
Bilgehan Karadag; Bulent Vatan; Yalcin Hacioglu; Dursun Duman; Murat Baskurt; Ibrahim Keles; Zeki Ongen; Vural Ali Vural
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Publication Detail:
Type:  Journal Article     Date:  2009-07-22
Journal Detail:
Title:  Heart and vessels     Volume:  24     ISSN:  1615-2573     ISO Abbreviation:  Heart Vessels     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-23     Completed Date:  2009-10-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8511258     Medline TA:  Heart Vessels     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  247-53     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Cerrahpasa School of Medicine, Istanbul University, Istanbul 34098, Turkey, karadag@istanbul.edu.tr
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / complications*,  drug therapy,  enzymology,  mortality
Aged
Biological Markers / blood
C-Reactive Protein / metabolism
Electrocardiography
Female
Humans
Inflammation Mediators / blood*
Male
Middle Aged
Myocardial Infarction / drug therapy*,  enzymology,  etiology,  mortality
Peroxidase / blood*
Predictive Value of Tests
Thrombolytic Therapy* / adverse effects,  mortality
Treatment Outcome
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Inflammation Mediators; 9007-41-4/C-Reactive Protein; EC 1.11.1.7/Peroxidase

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