Diagnostic value of MPO plasma levels in patients admitted for suspected myocardial infarction
Diagnostic value of MPO plasma levels in patients admitted for suspected myocardial infarction
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DOI：
10.1016/j.ijcard.2010.08.015
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发表时间：
2011-12-15
影响因子：
3.5
通讯作者：
Baldus, Stephan
中科院分区：
文献类型：
--
作者：
Rudolph, Volker;Goldmann, Britta U.;Baldus, Stephan
背景：髓过氧化物酶(MPO)除了在动脉粥样硬化中已被公认的作用外，作为心血管疾病的预后指标也受到关注。以前的研究对MPO进行了回溯性评估，并在单个时间点进行了评估。本研究旨在前瞻性评价MPO在胸痛患者中的预后信息。方法：对274例连续入院的胸痛患者进行血浆MPO水平测定。结果：共有100例(36.5%)患者最终诊断为急性心肌梗死(AMI)。急性心肌梗死患者MPO水平明显高于非急性心肌梗死患者。重要的是，即使肌钙蛋白I(TnI)为阴性(临界值：0.032 ng/ml)，最终诊断为急性心肌梗死的患者的MPO水平也会升高。总体而言，MPO的阴性预测值(NPV)为85.5%(95%可信区间：82.6-88.4)，诊断急性心肌梗死的敏感性为80.0%(95%CI：75.8-84.2)，而TNI的NPV为91.7%(95%CI：89.5-94.0)，敏感性为85.9%(95%CI：82.3-89.5)。对于出现症状的患者
Background: Besides its well-established role in atherosclerosis, myeloperoxidase (MPO) has gained attention as a prognostic indicator in cardiovascular disease. Previous studies assessed MPO retrospectively and at a single time point. The current study aimed to evaluate the prognostic information of MPO prospectively and in consecutive measurements in patients presenting with chest pain.Methods: MPO plasma levels were determined in 274 consecutive chest pain patients admitted to the emergency room.Results: A total of 100 patients (36.5%) were finally diagnosed for acute myocardial infarction (AMI). Patients with AMI had significantly higher MPO levels than patients without AMI. Importantly, MPO levels were elevated in patients finally diagnosed for AMI even when troponin I (TNI) was negative (cutoff: 0.032 ng/ml). Overall, MPO yielded a negative predictive value (NPV) of 85.5% (95% confidence interval (CI): 82.6-88.4) and a sensitivity for diagnosing AMI of 80.0% (95% CI: 75.8-84.2) compared to a NPV of 91.7% (95% CI: 89.5-94.0) and a sensitivity of 85.9% (95% CI: 82.3-89.5) for TNI. For patients with a symptom onset of