Use of myeloperoxidase for risk stratification in acute heart failure
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Use of myeloperoxidase for risk stratification in acute heart failure. / Reichlin, Tobias; Socrates, Thenral; Egli, Patrick; Potocki, Mihael; Breidthardt, Tobias; Arenja, Nisha; Meissner, Julia; Noveanu, Markus; Reiter, Mirjam; Twerenbold, Raphael; Schaub, Nora; Buser, Andreas; Mueller, Christian.
in: CLIN CHEM, Jahrgang 56, Nr. 6, 01.06.2010, S. 944-951.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Use of myeloperoxidase for risk stratification in acute heart failure
AU - Reichlin, Tobias
AU - Socrates, Thenral
AU - Egli, Patrick
AU - Potocki, Mihael
AU - Breidthardt, Tobias
AU - Arenja, Nisha
AU - Meissner, Julia
AU - Noveanu, Markus
AU - Reiter, Mirjam
AU - Twerenbold, Raphael
AU - Schaub, Nora
AU - Buser, Andreas
AU - Mueller, Christian
PY - 2010/6/1
Y1 - 2010/6/1
N2 - BACKGROUND: Myeloperoxidase (MPO) is a biomarker of inflammation and oxidative stress produced by neutrophils, monocytes, and endothelial cells. Concentrations of MPO predict mortality in patients with chronic heart failure. This study sought to investigate the diagnostic accuracy and prognostic value of MPO in patients with acute heart failure (AHF). METHODS: We prospectively enrolled 667 patients presenting to the emergency department with dyspnea and observed them for 1 year. MPO and B-type natriuretic peptide (BNP) were measured at presentation. Two independent cardiologists adjudicated final discharge diagnoses. RESULTS: MPO concentrations were similar in patients with AHF (n = 377, median 139 pmol/L) and patients with noncardiac causes of dyspnea (n = 290, median 150 pmol/L, P = 0.26). The diagnostic accuracy of MPO for AHF was limited [area under the ROC curve (AUC) 0.53] and inferior to that of BNP (AUC 0.95, P<0.001). In patients with AHF, MPO concentrations above the lowest tertile (MPO>99 pmol/L) were associated with significantly increased 1-year mortality (hazard ratio 1.58, P = 0.02). The combination of MPO(≤99 vs >99 pmol/L) and BNP (median of ≤847 vs >847 ng/L) improved the prediction of 1-year mortality (hazard ratio 2.80 for both variables increased vs both low, P < 0.001). After adjustment for cardiovascular risk factors in multivariable Cox proportional hazard analysis, increases in MPO contributed significantly toward the prediction of 1-year mortality (hazard ratio 1.51, P = 0.045). CONCLUSIONS: MPO is an independent predictor of 1-year mortality in AHF, is additive to BNP, and could be helpful in identifying patients with a favorable prognosis despite increased BNP concentrations.
AB - BACKGROUND: Myeloperoxidase (MPO) is a biomarker of inflammation and oxidative stress produced by neutrophils, monocytes, and endothelial cells. Concentrations of MPO predict mortality in patients with chronic heart failure. This study sought to investigate the diagnostic accuracy and prognostic value of MPO in patients with acute heart failure (AHF). METHODS: We prospectively enrolled 667 patients presenting to the emergency department with dyspnea and observed them for 1 year. MPO and B-type natriuretic peptide (BNP) were measured at presentation. Two independent cardiologists adjudicated final discharge diagnoses. RESULTS: MPO concentrations were similar in patients with AHF (n = 377, median 139 pmol/L) and patients with noncardiac causes of dyspnea (n = 290, median 150 pmol/L, P = 0.26). The diagnostic accuracy of MPO for AHF was limited [area under the ROC curve (AUC) 0.53] and inferior to that of BNP (AUC 0.95, P<0.001). In patients with AHF, MPO concentrations above the lowest tertile (MPO>99 pmol/L) were associated with significantly increased 1-year mortality (hazard ratio 1.58, P = 0.02). The combination of MPO(≤99 vs >99 pmol/L) and BNP (median of ≤847 vs >847 ng/L) improved the prediction of 1-year mortality (hazard ratio 2.80 for both variables increased vs both low, P < 0.001). After adjustment for cardiovascular risk factors in multivariable Cox proportional hazard analysis, increases in MPO contributed significantly toward the prediction of 1-year mortality (hazard ratio 1.51, P = 0.045). CONCLUSIONS: MPO is an independent predictor of 1-year mortality in AHF, is additive to BNP, and could be helpful in identifying patients with a favorable prognosis despite increased BNP concentrations.
UR - http://www.scopus.com/inward/record.url?scp=77953013954&partnerID=8YFLogxK
U2 - 10.1373/clinchem.2009.142257
DO - 10.1373/clinchem.2009.142257
M3 - SCORING: Journal article
C2 - 20413430
AN - SCOPUS:77953013954
VL - 56
SP - 944
EP - 951
JO - CLIN CHEM
JF - CLIN CHEM
SN - 0009-9147
IS - 6
ER -