scholarly journals Prognostic Role of Elevated Myeloperoxidase in Patients with Acute Coronary Syndrome: A Systemic Review and Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Andrew R. Kolodziej ◽  
Mohamed Abo-Aly ◽  
Eman Elsawalhy ◽  
Charles Campbell ◽  
Khaled M. Ziada ◽  
...  

Background. Myocardial inflammation following acute ischemic injury has been linked to poor cardiac remodeling and heart failure. Many studies have linked myeloperoxidase (MPO), a neutrophil and inflammatory marker, to cardiac inflammation in the setting of acute coronary syndrome (ACS). However, the prognostic role of MPO for adverse clinical outcomes in ACS patients has not been well established. Methods. MEDLINE and Cochrane databases were searched for studies from 1975 to March 2018 that investigated the prognostic value of serum MPO in ACS patients. Studies which have dichotomized patients into a high MPO group and a low MPO group reported clinical outcomes accordingly and followed up patients for at least 30 days to be eligible for enrollment. Data were analyzed using random-effects model. Sensitivity analyses were conducted for quality control. Results. Our meta-analysis included 13 studies with 9090 subjects and a median follow-up of 11.4 months. High MPO level significantly predicted mortality (odds ratio (OR) 2.03; 95% confidence interval (CI): 1.40-2.94; P<0.001), whereas it was not significantly predictive of major adverse cardiac events and recurrent myocardial infarction (MI) (OR 1.28; CI: 0.92-1.77, P=0.14 and OR 1.23; CI: 0.96-1.58, P=0.101, respectively). Hypertension, diabetes mellitus, and age did not affect the prognostic value of MPO for clinical outcomes, whereas female gender and smoking status have a strong influence on the prognostic value of MPO in terms of mortality and recurrent MI (metaregression coefficient -8.616: 95% CI -14.59 to -2.633, P=0.0048 and 4.88: 95% CI 0.756 to 9.0133, P=0.0204, respectively). Conclusions. Our meta-analysis suggests that high MPO levels are associated with the risk of mortality and that MPO can be incorporated in risk stratification models that guide therapy of high-risk ACS patients.

2014 ◽  
Vol 115 (suppl_1) ◽  
Author(s):  
Andrew R Kolodziej ◽  
Charles L Campbell ◽  
Richard Charnigo ◽  
Raphael Twerenbold ◽  
Christian Mueller ◽  
...  

BACKGROUND: It has been shown that Myeloperoxidase (MPO) is intimately involved in pathogenesis of atherosclerosis and Acute Coronary Syndrome (ACS). Small studies have shown that high levels of MPO are a poor prognostic factor in patients presenting with ACS. However, due to the small nature of these studies, the relationship between MPO and outcomes has not been confirmed. Here we aimed to examine the prognostic value of MPO in patients with ACS. METHODS: We performed a meta-analysis to compare the long-term prognosis of ACS patients with high MPO and low MPO levels. The literature was retrieved by formal searches of electronic databases (PubMed, EMBASE, Medline, OVID, and web of knowledge) from inception to November 2013. A total of 16 trials were included in this meta-analysis involving 10572 patients. Data were analyzed using random-effects model and study quality was assessed using appropriate scales. RESULTS: High MPO group was associated with overall worse outcomes than low MPO group in terms of recurrent myocardial infarction (9% [211 of 2336] vs. 7.7% [240 of 3101], odds ratio [OR] 1.4, 95% confidence interval [CI]: 0.92-2.15, p 0.11); all cause mortality (8% [236 of 2920] vs. 5% [209 of 4263], OR 1.83, 95% CI: 1.31-2.54, p <0.0004) and Major Adverse Cardiovascular Events (MACE) (24% [334 of 1400] vs. 14% [133 of 949], OR 2.04, 95% CI: 1.46-2.85, p< 0.0001) (Figure). CONCLUSIONS: In this meta-analysis examining the long-term outcomes in ACS patients, high MPO levels were associated with worse outcomes. These observations support prospective trials tailoring more aggressive therapy to patients with suspected worse prognosis.


PLoS ONE ◽  
2020 ◽  
Vol 15 (8) ◽  
pp. e0238288
Author(s):  
Jiapeng Lu ◽  
Siming Wang ◽  
Guangda He ◽  
Yanping Wang

Angiology ◽  
2020 ◽  
Vol 71 (9) ◽  
pp. 831-839
Author(s):  
Nuccia Morici ◽  
Valentina Molinari ◽  
Silvia Cantoni ◽  
Andrea Rubboli ◽  
Laura Antolini ◽  
...  

Individual parameters of complete blood count (CBC) have been associated with worse outcome in patients with acute coronary syndrome (ACS). However, the prognostic role of CBC taken as a whole has never been evaluated for long-term incidence of major adverse cardiovascular events (MACEs). Patients were grouped according to their hematopoietic cells’ inflammatory response at different time points during hospital stay. Patients with admission white blood cell count >10 × 109/L, discharge hemoglobin <120 g/L, and discharge platelet count >250 × 109/L were defined as “high-risk CBC.” Among 1076 patients with ACS discharged alive, 129 (12%) had a “high-risk CBC” and 947 (88%) had a “low-risk CBC.” Patients with “high-risk CBC” were older and had more comorbidities. Over a median follow-up of 665 days, they experienced a higher incidence of MACE compared to “low-risk CBC” patients (18.6% vs 8.1%). After adjustment for age, age-adjusted Charlson comorbidity index, female sex, cardiac arrest, suboptimal discharge therapy, coronary artery bypass, and ejection fraction, a high-risk CBC was significantly associated with increased MACE occurrence (adjusted hazard ratio 1.80; 95% CI: 1.09-3.00). The CBC was a prognostic marker in patients with ACS, and its evaluation at admission and discharge could better classify patient’s risk and improve therapeutic management.


2014 ◽  
Vol 15 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Antonino Mignano ◽  
Valentina Pitruzzella ◽  
Gaspare Arnone ◽  
M. Teresa Arnone ◽  
Antonino Rotolo ◽  
...  

2013 ◽  
Vol 34 (6) ◽  
pp. 379-386 ◽  
Author(s):  
Jing He ◽  
Fengmei Zhang ◽  
Ying Wu ◽  
Wei Zhang ◽  
Xiaoli Zhu ◽  
...  

BACKGROUND: Recent studies have shown that microRNAs (miRNA) have prognostic values in cancers. This meta-analysis seeks to summarize the global predicting role of miR-155 for survival in patients with a variety of carcinomas.METHODS: Eligible studies were identified through multiple search strategies. Data were extracted from studies investigating the relationship between miR-155 expression and survival in cancer patients. Combined hazard ratios (HRs) of miR-155 for outcome were analyzed.RESULTS: A total of 16 studies dealing with various carcinomas were included for this meta-analysis. For overall survival, higher miR-155 expression could significantly predict worse outcome with the pooled HR of 2.057 (95% CI: 1.392–3.039). For relapse or progress-free survival, elevated miR-155 was also a significant predictor, with a combined HR of 1.918 (95% CI: 1.311–2.806,). In addition, subgroup analysis showed that higher expression of miR-155 had the trends to predict worse outcome in lung cancer. However, the HRs did not reach the statistical significance.CONCLUSION: Our findings suggest that miR-155 detection has a prognostic value in cancer patients. Regularly measuring miR-155 expression may be useful in clinical practice.


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