Myeloperoxidase as prognostic factor for atrial fibrillation development in patients with ST-segment elevation myocardial infarction

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Background Arrhythmia is among the most common and severe myocardial infarction complications. Myeloperoxidase as an important immune factor can be linked to atrial fibrillation (AF) development. Previous studies indicated myeloperoxidase (MPO) as a significant mortality predictor in ST-segment elevation myocardial infarction (STEMI). The MPO role in prognosis for adverse clinical outcomes, as atrial fibrillations in STEMI patients remains not fully understood. The purpose of the investigation was to examine the MPO in prognosis of adverse outcomes presented by atrial fibrillations in patients with STEMI. Methods The study included 233 STEMI patients, 112 males, 121 females, and average age 67.87±7.11 years. Follow-up period was 14 days. Adverse outcome was observed and included atrial fibrillations. Plasma MPO levels were determined by ELISA, MPO was collected on admission. Results Patients with indicated adverse effects showed significantly increased MPO levels compared to those without ones, 169.91 IQR [89.45; 201.98] ng/ml vs 81.4 [33.91;181.29] ng/ml; p < 0.001. A ROC analysis determined a MPO cut-off value for arrhythmia (AF) development of 176.53 ng/ml with a sensitivity of 71.1% and specificity of 77.6%, AUC 0.732; 95 % CI 0.677-0.782; p <0.001. Elevated MPO concentration was a significant predictor for AF (OR 1.115; 95% CI: 1.007-1.841; p<0.001). Even adjusted for age and sex MPO remained significantly predictive for arrhythmia development. Conclusions The study suggests that increased levels of MPO are associated with the higher risk of atrial fibrillation. MPO could be a possible significant factor for therapy optimization in high-risk STEMI patients.