The Difference Of Myeloperoxidase Levels In Patients Before And After Interventional Treatment And The Clinical Signilfcance

【Background and Objective】Up to10years till now, interventional therapy for coronary heart disease(CHD) havedeveloped drastically, percutaneous coronary intervention(PCI) and stent implantation hasbecome one of the primary method of coronary revascularization. In this experiment, wecompared with the plasma myeloperoxidase (MPO) concentrations in patients pre-andpost-coronary stent, and investigated the factors affecting Δ MPO levesl change.Moreover, we evaluated whether plasma Δ MPO concentrations could predict theincidence of the major adverse cardiac events (MACEs) in the setting of the stentpatients.【Methods】We selected from May2010to July2010,60cases of patients in the hospital ofCardiology, who underwent percutaneous coronary intervention. They were divided twogroups,44patients who were performed stent implantation were as the stent group, and16patients who were performed simple coronary angiography were as angiography group.We determined plasma MPO levels by ELISA, and measured hs-CRP, IL-6, neutrophilswith all patients. Then we followed for12months and recorded the major adverse cardiacevents (MACEs) in all the patients. Comparison the differences between the two groups ofpatients’ ΔMPO levels, we used ROC curves to evaluate the value that ΔMPO couldpredict the long-term prognosis after stenting. Finally we made use of multiple logisticregression analysis to calculate the correlation between MACEs and ΔMPO level or othercoronary risk factors.【Results】1．Peripheral blood MPO、hs-CRP and IL-6levels were significantly higher after PCIin the stent group and angiography group of patients than pre-PCI.(P <0.05).2．Comparison with ΔMPO and ΔIL-6levels in the Stent group and the contrast grouphas significantly increased (P <0.05), but no significant difference between the two groupsin Δhs-CRP levels (P>0.05).3．ΔMPO levels have no statistically significant (P>0.05) in single stent,、doublestents、three stents and above of patients. ΔMPO levels have not increased with theincrease of stent number.4．There was a weak positive correlation between with ΔMPO and Gensini score.Stent group patients to the quartile of the Gensini score will be divided into three groups,which compared ΔMPO levels with the patients in simple contrast. The resultsshow that patients with stent implantation, their plasma ΔMPO level is not rising with theGensini score increased (P>0.05), but the difference which was compared withangiography alone in patients were significantly (P <0.05).5．plasma ΔMPO concentrations predicting adverse cardiac events (MACEs) in thesetting of the stent patients was statistically significant (P <0.05). According to the ROCcurve of MACEs, we selected the cut-off point for ΔMPO=67.91ng/ml. The predictivesensitivity is80.0%, and the specificity is56.4%. ΔMPO predictive value of the incidenceof MACEs in stent implantation patients was significantly better than the preoperativeplasma MPO concentration.6．There was a weak positive correlation between the ΔMPO levels and age. logistismulti-factor regression analysis showed that ΔMPO can be an independent predictor of thestent implantation patients in the incidence of adverse cardiac events after12months.【Conclusion】There was a significantly increase of plasma MPO concentration in the patients whounderwent stent implantation which compared with the patients with only coronaryangiography. Plasma ΔMPO level seem a good biomaker for predicting the risk in stent implantationpatients during12-month follow up.