Myeloperoxidase predicts progression of carotid stenosis in states of low high-density lipoprotein cholesterol

被引:49
作者
Exner, Markus
Minar, Erich
Mlekusch, Wolfgang
Sabeti, Schila
Amighi, Jasinin
Lalouschek, Wolfgang
Maurer, Gerald
Bieglmayer, Christian
Kieweg, Heidi
Wagner, Oswald
Schillinger, Martin
机构
[1] Med Univ Vienna, Dept Med, A-1090 Vienna, Austria
[2] Med Univ Vienna, Dept Chem Lab Diagnost, A-1090 Vienna, Austria
[3] Med Univ Vienna, Dept Angiol, A-1090 Vienna, Austria
[4] Med Univ Vienna, Dept Neurol, A-1090 Vienna, Austria
[5] Med Univ Vienna, Dept Cardiol, A-1090 Vienna, Austria
关键词
D O I
10.1016/j.jacc.2006.01.067
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVES We investigated the effect of myeloperoxidase (MPO) on progression of carotid stenosis in states of high and low high-density tipoprotein-cholesterol (HDL-C) and low-density lipoprotein-cholesterol (LDL-C) levels. BACKGROUND Myeloperoxidase is pivotally involved in the pathogenesis of atherosclerosis. In vitro data suggest that MPO exerts deleterious effects via oxidative modulation of lipoproteins. METHODS We prospectively studied 1,019 of 1,268 consecutive patients who were asymptomatic with respect to carotid artery disease. Patients underwent serial carotid ultrasound investigations at baseline and after a follow-up interval of median 7.5 months (range 6 to 9 months), categorizing carotid arteries as 0% to 29%, 30% to 49%, 50% to 69%, 70% to 89%, or 90% to 99% stenosed or occluded. The MPO, HDL-C, and LDL-C levels were measured at baseline, grouped by medians, and correlated with progression of carotid atherosclerosis. RESULTS Progression of carotid atherosclerosis was found in 100 of 1,019 patients (9.8%). Myeloperoxidase (p = 0.014) but not HDL-C (p = 0.95) or LDL-C (p = 0.30) were associated with progressive disease. However, MPO >= 310 ng/ml was significantly associated with progressive disease (adjusted odds ratio [OR] 2.57, 95% confidence interval [CI] 1.39 to 4.75) only in patients with HDL-C levels < 49 mg/dl. Otherwise, in patients with higher HDL-C levels (>= 49 mg/dl), MPO >= 310 ng/ml did not predict disease progression (adjusted OR 1.42, 95% CI 0.72 to 2.78). No interaction of MPO with LDL-C was observed. CONCLUSIONS Myeloperoxidase was associated with progression of carotid atherosclerosis in patients with HDL cholesterol levels below 49 mg/dl.
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页码:2212 / 2218
页数:7
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