Myeloperoxidase and global longitudinal strain in prognostication of clinical events after ST segment elevation myocardial infarction

Abstract

Elevated levels of several inflammatory cytokines and chemokines, such as myeloperoxidase (MPO) and some characteristics of damaged myocardium such as myocardial deformation (global longitudinal strain — GLS) seem to be promising biomarkers for acute coronary syndrome, but their predictive ability for clinical outcomes amongst ST segment elevation myocardial infarction (STEMI) patients having obesity remained unclear.
 The aim of the study was to to determine the impact of MPO and GLS on prediction of 1‑year combined clinical events in STEMI patients successfully treated with primary percutaneous coronary intervention (PCI) depending on abdominal obesity presentation.
 Materials and methods. We prospectively enrolled 102 individuals with STEMI who were successfully treated with primary PCI. All patients gave their consent to participate in the study. The biomarkers (MPO, cardiac troponins), echocardiographic and Doppler parameters including global longitudinal strain (GLS) were evaluated at the baseline.
 Results. The MPO level in the entire population of patients with STEMI was 129.45 [48.48 — 179.70] ng/ml. The group was divided into two cohorts depending on the median level of MPO (≥ 98.34 ng/ml and < 98.34 ng/ml). We observed 26 combined end‑points (10 and 17 in patients with MPO ³ 98.34 ng/ml and < 98.34 ng/ml, respectively (F test = 0.064285; ε2 = 4.29; р = 0.046). Multivariate linear regression showed that the only GLS and MPO remained independent predictors for the clinical outcomes.
 Conclusions. Global longitudinal strain was the best predictor for 1‑year combined clinical outcomes in STEMI patients who were undergone successful primary PCI. Body fat accumulation seems to show borderline significance when compared with GLS, while it was sufficiently better than MPO.