Association between Myeloperoxidase and High Sensitive Troponin I on Myocardial Contractility in Acute Myocardial Infarction Patients


  • Trisulo Wasyanto Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sebelas Maret/Dr. Moewardi Hospital, Surakarta
  • Budi Patria Meilus Departmentof Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sebelas Maret
  • Ahmad Yasa Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sebelas Maret/Dr. Moewardi Hospital, Surakarta


Background: Myeloperoxidase (MPO) levels have been shown to have prognostic values for death events in acute myocardial infarction (AMI) patients. Increased levels of high sensitive troponin I (hs Trop I) are associated with poorer prognosis in AMI patients. This study aimed to determine the association between levels of MPO and hs troponin I at admisson on myocardial contractility in AMI patients.

Subjects and Method: This was a prospective observational analytic study, conducted at Dr. Moewardi General Hospital, Surakarta, from November1, 2018 to January 31, 2019. The study subjects were patients who were diagnosed with AMI. A total of 23 patients were included in this study; 15 patients with ST elevation myocardial infarction (STEMI) and 8 with non ST elevation myocardial infarction (NSTEMI). The dependent variable was myocardial contractility. The inde­pendent variables were MPO and hs Trop I. Blood tests for MPO and hs Trop I was measured at admission and the left ventricular ejection fraction (LVEF) was measured when predis­charge by the Simpson method to examine myo­cardial contractility. The data were analyzed by Pearson correlation run on SPSS 22.  

Results: hs Trop I (r= -0.53; p= 0.009) and MPO (r= -0.15; p=0.487) decreased LVEF.

Conclusion: Hs Trop I at admission has a correlation with myocardial contractility, and no correlation of MPO at admission with myocardial contractility in AMI patients.

Keywords: Myeloperoxidase, High sensitive Troponin I, Acute myocardial infarction

Correspondence: Trisulo Wasyanto. Department of Cardiology and Vascular Medicine, Faculty of Medicine, Uni­ver­sitas Sebelas Maret/ Dr. Moewardi Hospital. Jl. Kol. Sutarto 132, Surakarta 57126, Central Java, Indonesia. Email:

Indonesian Journal of Medicine (2020), 05(04): 265-271




Askari AT, Brennan ML, Zhou X, Drinko J, Morehead A, Thomas J, Topol E, Hazen S, Penn M (2003). Myeloperoxidase and plasminogen activator inhibitor 1 play a central role in ventricular re-modeling after myocardial infarction. J Exp Med. 197(5): 615-24. https://doi.-org/10.1084/jem.20021426.

Baldus S, Heitzer T, Eiserich JP, Lau D, Mollnau H, Ortak M, Petri S, et al. (2004). Myeloperoxidase enhances nitric oxide catabolism during myo-cardial ischemia and reperfusion. Free Radical Biology and Medicine, 37(6): 902-11.

Balitbang Kemenkes RI (2013). Riset Kese-hatan Dasar (RISKESDAS). Jakarta.

Chan D, Ng LL (2010). Biomarkers in Acute Myocardial Infarction. BMC Medicine. 8: 34-45.

Chia S, Senatore F, Raffel OC, Lee H, Wack-ers FJT, Jang IK (2008). Utility of car-diac biomarkers in predicting infarct size, left ventricular function, and clini-cal outcome after primary percuta-neous coronary intervention for ST-segment elevation myocardial infarc-tion. JACC Cardiovasc Interv. 1(4): 415-23.

de Mello BHG, Oliveira GBF, Ramos RF, Lopes BBC, Barros CBS, Carvalho EO, Teixeira FBP, et al. (2014). Validation of the Killip-Kimball classification and late mortality after acute myocardial infarction. Arq Bras Cardiol. 103(2): 107-17.

Deuschl F, Klinke A, Friedrichs K, Knappe D, Weinberger F, Müllerleile K, Wester-mann D, et al. (2014). Myeloperoxidase is critically linked to the development of diastolic heart failure following pressure overload. The Journal of Heart and Lung Transplantation,

(4): S164.

Heinecke JW (2003). Oxidative stress: new approaches to diagnosis and prognosis in atherosclerosis. Am J Cardiol. 91(3A):12A–16A. (02)03145-4.

Kacprzak M, Zielinska M (2016). Prognostic value of myeloperoxidase concentration in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary inter-vention. Int J Cardiol. 223:452-7.

Kaya MG, Yalcin R, Okyay K, Poyraz F, Bayraktar N, Pasaoglu H, Boyaci B, Cengel A (2012). Potential role of plas-ma myeloperoxidase level in predicting long-term outcome of acute myocardial infarction. Texas Heart Institute Jour-nal, 39(4): 500-6.

Khan HA, Alhomida AS, Sobki SH, Habib SS, Al Aseri Z, Khan AA, Al Moghairi A (2013). Serum markers of tissue damage and oxidative stress in patients with acute myocardial infarction. Bio-medical Research. 24(1): 15-20.

Khan MH, Islam MN, Aditya GP, Islam MZ, Bhuiyan AS, Saha B, Bhowmick K, et al. (2017). Correlation of Troponin-I level with left ventricular ejection fraction and in-hospital outcomes after first attack of non-ST segment elevation myocardial infarction.

Mymensingh Med J. 26(4): 721-31.

Pashkow FJ (2011). Oxidative stress and inflammation in heart disease: Do antioxidants have a role in treatment and/or prevention?. Int J Inflam. 514-623.

Podrez EA, Abu-Soud HM, Hazen SL (2000). Myeloperoxidase-generated oxidants and atherosclerosis. Free Radic Biol Med. 28(12): 1717–1725. (00)00229-x.

Stankovic S, Asanin M, Trifunovic D, Majkic-Singh N, Ignjatovic S, Mrdovic I, Matic D (2012). Time-dependent changes of myeloperoxidase in relation to in-hospital mortality in patients with the first anterior ST-segment elevation myocardial infarction treated by pri-mary percutaneous coronary interven-tion. Clin Biochem. 45(7-8): 547-51.

Thygesen K, Alpert J, Jaffe A, Chaitman B, Bax J, Morrow D, White H (2018). Fourth universal definition of myocar-dial infarction. Global Heart, 13(4): 305-38.

Twerenbold R, Boeddinghaus J, Nestelberger T, Wildi K, Rubini GM, Badertscher P, Mueller C (2017). Clinical use of high-sensitivity cardiac troponin in patients with suspected myocardial infarction.J Am Coll Cardiol. 70(8): 996-1012.

Widimsky P, Wijns W, Fajadet J, De Belder M, Knot J, Aaberge L, Andrikopoulos G, et al. (2009). Reperfusion therapy for ST elevation acute myocardial infarction in Europe: description of the current situation in 30 countries. Eur Heart J. 31(8): 943-57.

Wu E, Ortiz JT, Tejedor P, Lee DC, Bucci-arelli-Ducci C, Kansal P, Carr JC, Holly TA, Lloyd-Jones D, Klocke FJ, Bonow RO (2008). Infarct size by contrast enhanced cardiac magnetic resonance is a stronger predictor of outcomes than left ventricular ejection fraction or end-systolic volume index: prospective cohort study. Heart, 94(6): 730-6.