Serum Myeloperoxidase Levels Are Associated with the Future Risk of Coronary Artery Disease in Apparently Healthy Individuals: the Epic-norfolk Prospective Population Study.
From: Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands.
Journal of the American College of Cardiology
- Publish Date: Jul 2007
- ISSN: 1558-3597
- Volume: 50
- Issue: 2
- Pages: 159-65
- Medium: Internet
- Language: English
- Citation (JAMA): Meuwese Marijn C, Stroes Erik S G, Hazen Stanley L, et al. Serum Myeloperoxidase Levels Are Associated with the Future Risk of Coronary Artery Disease in Apparently Healthy Individuals: the Epic-norfolk Prospective Population Study.. J. Am. Coll. Cardiol. Jul 2007;50:159-65
Abstract
OBJECTIVES: We evaluated whether serum myeloperoxidase (MPO) levels are associated with the risk of future development of coronary artery disease (CAD) in apparently healthy individuals. BACKGROUND: An enzyme of the innate immune system, MPO exhibits a wide array of proatherogenic effects. These include induction of oxidative damage to low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol and promotion of plaque vulnerability. Recent studies revealed that MPO independently predicts adverse outcomes in patients with chest pain or suspected acute coronary syndrome. METHODS: Myeloperoxidase was measured in baseline samples of a case-control study nested in the prospective EPIC (European Prospective Investigation into Cancer and Nutrition)-Norfolk population study. Case subjects (n = 1,138) were apparently healthy men and women who developed CAD during 8-year follow-up. Control subjects (n = 2,237), matched for age, gender, and enrollment time, remained free of CAD. RESULTS: The MPO levels were significantly higher in case subjects than in control subjects and correlated with C-reactive protein (CRP) (rho = 0.25; p < 0.001) and white blood cell count (rho = 0.33; p < 0.001). Risk of future CAD increased in consecutive quartiles of MPO concentration, with an odds ratio (OR) of 1.49 in the top versus bottom quartile (95% confidence interval [CI] 1.20 to 1.84; p < 0.001). After adjustment for traditional risk factors, the OR in the top quartile remained significant at 1.36 (95% CI 1.07 to 1.73). Elevated MPO levels (>728 pmol/l) similarly predicted increased risk of future CAD among participants with either LDL-cholesterol <130 mg/dl, HDL-cholesterol >50 mg/dl, or CRP <2.0 mg/l (OR 1.52 [95% CI 1.21 to 1.91], 1.59 [95% CI 1.24 to 2.05], and 1.42 [95% CI 1.14 to 1.77)], respectively). CONCLUSION: Elevated MPO levels predict future risk of CAD in apparently healthy individuals. This study suggests that inflammatory activation precedes the onset of overt CAD by many years.
Mesh Headings (Keywords): Aged, Biological Markers, Blood Pressure, Case-Control Studies, Coronary Artery Disease, Female, Humans, Lipids, Male, Middle Aged, Peroxidase, Prospective Studies, Risk Factors
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