Association between Myeloperoxidase and High Sensitive Troponin I on Myocardial Contractility in Acute Myocardial Infarction Patients
Abstract
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: trisulo.wasyanto@gmail.com.
Indonesian Journal of Medicine (2020), 05(04): 265-271
https://doi.org/10.26911/theijmed.2020.05.04.01.
References
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. https://doi.org/10.1016/j.free-radbiomed.2004.06.003.
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.https://doi.org/10.1186/1741-7015-8-34
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. https://doi.org/10.1016/j.jcin.20-08.04.010.
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. https://dx.doi.org/10.5935%2-Fabc.20140091.
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.https://doi.org/10.1016/j.healun.2014.01.440.
Heinecke JW (2003). Oxidative stress: new approaches to diagnosis and prognosis in atherosclerosis. Am J Cardiol. 91(3A):12A–16A. https://doi.org/10.-1016/s0002-9149 (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. https://doi.org/10.1016/j.ijcard.2016.-07.258.
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. http://fac.ksu.edu.sa/sites/default/files-/bio_medical_research_serum_mark-er_in_mi_2013.pdf.
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. https://dx.doi.org/10.4061%2F2-011%2F514623.
Podrez EA, Abu-Soud HM, Hazen SL (2000). Myeloperoxidase-generated oxidants and atherosclerosis. Free Radic Biol Med. 28(12): 1717–1725. https://doi.org/10.1016/s0891-5849 (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. https://doi.org/10.1016/j.clinbiochem.2012.02.015.
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. https://doi.org/10.1161/CIR.0000000000000617.
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. https://doi.org/10.1016/j.jacc.2017.0-7.718.
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. https://doi.org/10.1093/eurheartj/ehp492.
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. https://doi.org/10.1136/hrt.2007.12-2622.
