Estimation of Myeloperoxidase (MPO), Oxidized LDL and Glutathione (GSH) in Patients with Acute Myocardial Infarction (AMI) in Three Iraqi Hospitals | ||
| Iraqi Postgraduate Medical Journal | ||
| Article 17, Volume 21, Issue 4, October 2022, Pages 482-491 PDF (312.46 K) | ||
| DOI: 10.52573/ipmj.2021.177175 | ||
| Authors | ||
| Muataz Mohammed Ali Al-Qazzaz* 1; Mohammed Imran Hamzah1; Moayed Basheer Hamid2 | ||
| 1Department of Chemistry & Biochemistry, College of Medicine, Al-Nahrain University. | ||
| 2Department Of Internal Medicine, College of Medicine, Al-Nahrain University. | ||
| Abstract | ||
| BACKGROUND: Acute myocardial infarction (AMI) is a cardiovascular emergency that needs immediate diagnosis and treatment. Myeloperoxidase (MPO) an enzyme generated by active leukocytes, has been connected to atherosclerosis in a mechanistic way and earlier research has suggested that MPO could be employed as a diagnostic and analytical marker for AMI patients. Many cardiovascular disease ( CVD) events have been linked to oxidized-LDL (Ox-LDL) &Glutathione (GSH) . OBJECTIVE: Studies a new, rapidly rising, or cost-effective biomarker for the detection of AMI. PATIENTS AND METHODS: Eighty (80) patients & (40) control offered with chest pain presented to the Coronary Care Unit looking for medical help about their newly developed symptoms. Serum levels were measured by enzyme-linked immunosorbent assay (ELISA). RESULT: The result of this current study showed that a highly significant association between the serum concentration of MPO and the three groups study (p<0.001). In this present study, a higher significant difference is noted in the level of serum oxLDL in the STEMI group (p < 0.001) and (0.005) in the NSTEMI group. the higher significant difference is noted in the level of serum GSH in NSTEMI & STEMI compared with control (p < 0.001) and between the patents groups (p= 0.019) CONCLUSION : Myeloperoxidase(MPO) & GSH serum level is highly associated with AMI and can be used as a biomarker of early diagnosis, progression, and grading of AMI Increased serum concentrations of oxLDL are analytical of future AMI | ||
| Keywords | ||
| (MPO) Myeloperoxidase; (NSTEMI) non ST segment elevation myocardial infarction; (STEMI)ST segment Elevation Myocardial infarction | ||
| References | ||
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1. Zeng J, Huang J, Pan L. How to balance acute myocardial infarction and COVID-19: the protocols from Sichuan Provincial People’s Hospital. Intensive Care Med [Internet]. 2020;46:1111–13. Available from: https://doi.org/10.1007/s00134-020-05993-9 2. Gulati R, Behfar A, Narula J, Kanwar A, Lerman A, Cooper L, et al. Acute Myocardial Infarction in Young Individuals. Mayo Clin Proc [Internet]. 2020;95:136–56. Available from: https://doi.org/10.1016/j.mayocp.2019.05.001 3. Procopio A, De Rosa S, Covello C, Merola A, Sabatino J, De Luca A, et al. Mathematical model of the release of the CTNT and CK-MB cardiac biomarkers in patients with acute myocardial infarction. 2019 18th Eur Control Conf ECC 2019. 2019:1653–58. 4. Michaud K, Basso C, d’Amati G, Giordano C, Kholová I, Preston SD, et al. Diagnosis of myocardial infarction at autopsy: AECVP reappraisal in the light of the current clinical classification. Virchows Arch. 2020;476:179–94. 5. Chaikijurajai T, Tang WHW. Myeloperoxidase: a potential therapeutic target for coronary artery disease. Expert Opin Ther Targets [Internet]. 2020;24. Available from: https://doi.org/10.1080/14728222.2020.1762177 6. Hasan R, Lindarto D, Siregar GA, Mukhtar Z. The effect of bay leaf extract syzygium polyanthum (Wight) walp. on C-reactive protein (CRP) and myeloperoxidase (MPO) level in the heart of rat model of myocardial infarction. Med Glas. 2020;17:41–45. 7. Sitkov NO, Zimina TM, Karasev VA, Lemozerskii VE, Kolobov AA. Design of Peptide Ligands ( Aptamers ) for Determination of Myeloperoxidase Level in Blood Using Biochips. 2020;1599–603. 8. Love DT, Guo C, Nikelshparg EI, Brazhe NA, Sosnovtseva O, Hawkins CL. The role of the myeloperoxidase-derived oxidant hypothiocyanous acid (HOSCN) in the induction of mitochondrial dysfunction in macrophages. Redox Biol [Internet]. 2020;36:101602. Available from: https://doi.org/10.1016/j.redox.2020.101602 9. Daher J. Other forms of oxidized LDL : Emerging functions ( Review ). 2020;4–6. 10. Dominguez-Rodriguez A, Abreu-Gonzalez P, Garcia-Gonzalez M, Ferrer-Hita J, Vargas M, Reiter RJ. Elevated levels of oxidized low-density lipoprotein and impaired nocturnal synthesis of melatonin in patients with myocardial infarction. Atherosclerosis. 2005;180:101–5. 11. Malle E, Marsche G, Panzenboeck U, Sattler W. Myeloperoxidase-mediated oxidation of high-density lipoproteins: Fingerprints of newly recognized potential proatherogenic lipoproteins. Arch Biochem Biophys. 2006;445:245–55. 12. Bajic VP, Van Neste C, Obradovic M, Zafirovic S, Radak D, Bajic VB, et al. Glutathione “redox homeostasis” and its relation to cardiovascular disease. Oxid Med Cell Longev. 2019;2019. 13. Saraf J, Wanve M, Kalia K. Trigonelline therapy confers neuroprotection by reduced glutathione mediated myeloperoxidase expression in animal model of ischemic stroke. 2018; 14. Norman G. Likert scales, levels of measurement and the “laws” of statistics. Adv Heal Sci Educ. 2010;15:625–32. 15. Shi X, Zhu T, Ni J, Zhang R. The expression of myeloperoxidase in thrombi is associated with reduced heme oxygenase-1 induction and worse left ventricular remodeling in patients with acute ST-elevation myocardial infarction. Clin Cardiol. 2021;44:357–63. 16. Tan Y, Yang S, Chen R, Sheng Z, Zhou P, Liu C, et al. High Plasma Myeloperoxidase Is Associated with Plaque Erosion in Patients with ST-Segment Elevation Myocardial Infarction. J Cardiovasc Transl Res. 2020; 17. Wasyanto T, Meilus BP, Yasa A. Association between Myeloperoxidase and High Sensitive Troponin I on Myocardial Contractility in Acute Myocardial Infarction Patients. Indones J Med. 2020;5:265–71. 18. Nanoparticles S, Patients MI. Nano Biomed Eng Impact of Copper Oxide and Selenium Nanoparticles on the Activities of Myeloperoxidase and Gamma- Glutamyl Transferase Related Oxidative Stress of Myocardial Infarction Patients. 2021;13:165–71. 19. Trentini A, Rosta V, Spadaro S, Bellini T, Rizzo P, Vieceli Dalla Sega F, et al. Development, optimization and validation of an absolute specific assay for active myeloperoxidase (MPO) and its application in a clinical context: Role of MPO specific activity in coronary artery disease. Clin Chem Lab Med. 2020; 20. Sawada N, Obama T, Koba S, Takaki T, Iwamoto S. Circulating oxidized LDL , increased in patients with acute myocardial infarction , is accompanied by heavily modified HDL. J Lipid Res [Internet]. 2020;61(6):816–29. Available from: http://dx.doi.org/10.1194/jlr.RA119000312 21. Itabe H, Sawada N, Makiyama T, Obama T. Structure and dynamics of oxidized lipoproteins in vivo: Roles of high‐density lipoprotein. Biomedicines. 2021;9. 22. Lorenzon J, Quadros AS De, Weschenfelder C, Garofallo SB, Marcadenti A. Oxidative Stress Biomarkers, Nut-Related Antioxidants, and Cardiovascular Disease. 2020;(Cvd):1–15. 23. Moll J, Fogoros RN. The Causes and Effects of Oxidized LDL Cholesterol. Verywell Heal [Internet]. 2020;1–6. Available from: https://www.verywellhealth.com/what-is-oxidized-ldl-698079.
24. Vasilyev VB, Sokolov A V., Kostevich VA, Elizarova AY, Gorbunov NP, Panasenko OM. Binding of lactoferrin to the surface of low-density lipoproteins modified by myeloperoxidase prevents intracellular cholesterol accumulation by human blood monocytes. Biochem Cell Biol. 2020;1–22. 25. John M, Priyanka S, George JB, Maria E, Unni G. Oxidative stress parameters in atherosclerotic cardiovascular disease high and low risk score groups as indicators for acute myocardial infarction. 2021;10:1–7. 26. Matuz-mares D, Riveros-rosas H. Glutathione Participation in the Prevention of Cardiovascular Diseases. 2021; 27. Li Z, Zhang J, Li Y, Zhao S, Zhang P, Zhang Y, et al. Carbon dots based photoelectrochemical sensors for ultrasensitive detection of glutathione and its applications in probing of myocardial infarction. Biosens Bioelectron [Internet]. 2018;99:251–8. Available from: http://dx.doi.org/10.1016/j.bios.2017.07.065 28. Nowak RM, Christenson RH, Jacobsen G, McCord J, Apple FS, Singer AJ, et al. Performance of Novel High-Sensitivity Cardiac Troponin I Assays for 0/1-Hour and 0/2- to 3-Hour Evaluations for Acute Myocardial Infarction: Results From the HIGH-US Study. Ann Emerg Med [Internet]. 2020;76:1–13. Available from: https://doi.org/10.1016/j.annemergmed.2019.12.008 29. Welsh P, Preiss D, Hayward C, Shah ASV, McAllister D, Briggs A, et al. Cardiac Troponin T and Troponin i in the General Population: Comparing and Contrasting Their Genetic Determinants and Associations with Outcomes. Circulation. 2019;139:2754–64. 30. McDonaugh B, Whyte M. The Evolution and Future Direction of The Cardiac Biomarker. EMJ Cardiol. 2020;97–106. 31. Khan DA, Sharif MS, Khan FA. Diagnostic performance of high-sensitivity troponin T,myeloperoxidase,and pregnancy-associated plasma protein a assays for triage of patients with acute myocardial infarction. Korean J Lab Med. 2011;31:172–78. 32. Omran MM, Zahran FM, Kadry M, Belal AAM, Emran TM. Role of myeloperoxidase in early diagnosis of acute myocardial infarction in patients admitted with chest pain. J Immunoass Immunochem [Internet]. 2018;39:337–47. Available from: https://doi.org/10.1080/15321819.2018.1492423 33. Liu C, Xie G, Huang W, Yang Y, Li P, Tu Z. Elevated serum myeloperoxidase activities are significantly associated with the prevalence of ACS and high LDL-C levels in CHD patients. J Atheroscler Thromb. 2012;19:435–43. 34. Sawicki M, Sypniewska G, Kozinski M, Gruszka M, Krintus M, Obonska K, et al. Diagnostic efficacy of myeloperoxidase for the detection of acute coronary syndromes. Eur J Clin Invest. 2011;41:667–71. 35. Meisinger C, Baumert J, Khuseyinova N, Loewel H, Koenig W. Plasma oxidized low-density lipoprotein, a strong predictor for acute coronary heart disease events in apparently healthy, middle-aged men from the general population. Circulation. 2005;112:651–57.
1. Zeng J, Huang J, Pan L. How to balance acute myocardial infarction and COVID-19: the protocols from Sichuan Provincial People’s Hospital. Intensive Care Med [Internet]. 2020;46:1111–13. Available from: https://doi.org/10.1007/s00134-020-05993-9 2. Gulati R, Behfar A, Narula J, Kanwar A, Lerman A, Cooper L, et al. Acute Myocardial Infarction in Young Individuals. Mayo Clin Proc [Internet]. 2020;95:136–56. Available from: https://doi.org/10.1016/j.mayocp.2019.05.001 3. Procopio A, De Rosa S, Covello C, Merola A, Sabatino J, De Luca A, et al. Mathematical model of the release of the CTNT and CK-MB cardiac biomarkers in patients with acute myocardial infarction. 2019 18th Eur Control Conf ECC 2019. 2019:1653–58. 4. Michaud K, Basso C, d’Amati G, Giordano C, Kholová I, Preston SD, et al. Diagnosis of myocardial infarction at autopsy: AECVP reappraisal in the light of the current clinical classification. Virchows Arch. 2020;476:179–94. 5. Chaikijurajai T, Tang WHW. Myeloperoxidase: a potential therapeutic target for coronary artery disease. Expert Opin Ther Targets [Internet]. 2020;24. Available from: https://doi.org/10.1080/14728222.2020.1762177 6. Hasan R, Lindarto D, Siregar GA, Mukhtar Z. The effect of bay leaf extract syzygium polyanthum (Wight) walp. on C-reactive protein (CRP) and myeloperoxidase (MPO) level in the heart of rat model of myocardial infarction. Med Glas. 2020;17:41–45. 7. Sitkov NO, Zimina TM, Karasev VA, Lemozerskii VE, Kolobov AA. Design of Peptide Ligands ( Aptamers ) for Determination of Myeloperoxidase Level in Blood Using Biochips. 2020;1599–603. 8. Love DT, Guo C, Nikelshparg EI, Brazhe NA, Sosnovtseva O, Hawkins CL. The role of the myeloperoxidase-derived oxidant hypothiocyanous acid (HOSCN) in the induction of mitochondrial dysfunction in macrophages. Redox Biol [Internet]. 2020;36:101602. Available from: https://doi.org/10.1016/j.redox.2020.101602 9. Daher J. Other forms of oxidized LDL : Emerging functions ( Review ). 2020;4–6. 10. Dominguez-Rodriguez A, Abreu-Gonzalez P, Garcia-Gonzalez M, Ferrer-Hita J, Vargas M, Reiter RJ. Elevated levels of oxidized low-density lipoprotein and impaired nocturnal synthesis of melatonin in patients with myocardial infarction. Atherosclerosis. 2005;180:101–5. 11. Malle E, Marsche G, Panzenboeck U, Sattler W. Myeloperoxidase-mediated oxidation of high-density lipoproteins: Fingerprints of newly recognized potential proatherogenic lipoproteins. Arch Biochem Biophys. 2006;445:245–55. 12. Bajic VP, Van Neste C, Obradovic M, Zafirovic S, Radak D, Bajic VB, et al. Glutathione “redox homeostasis” and its relation to cardiovascular disease. Oxid Med Cell Longev. 2019;2019. 13. Saraf J, Wanve M, Kalia K. Trigonelline therapy confers neuroprotection by reduced glutathione mediated myeloperoxidase expression in animal model of ischemic stroke. 2018; 14. Norman G. Likert scales, levels of measurement and the “laws” of statistics. Adv Heal Sci Educ. 2010;15:625–32. 15. Shi X, Zhu T, Ni J, Zhang R. The expression of myeloperoxidase in thrombi is associated with reduced heme oxygenase-1 induction and worse left ventricular remodeling in patients with acute ST-elevation myocardial infarction. Clin Cardiol. 2021;44:357–63. 16. Tan Y, Yang S, Chen R, Sheng Z, Zhou P, Liu C, et al. High Plasma Myeloperoxidase Is Associated with Plaque Erosion in Patients with ST-Segment Elevation Myocardial Infarction. J Cardiovasc Transl Res. 2020; 17. Wasyanto T, Meilus BP, Yasa A. Association between Myeloperoxidase and High Sensitive Troponin I on Myocardial Contractility in Acute Myocardial Infarction Patients. Indones J Med. 2020;5:265–71. 18. Nanoparticles S, Patients MI. Nano Biomed Eng Impact of Copper Oxide and Selenium Nanoparticles on the Activities of Myeloperoxidase and Gamma- Glutamyl Transferase Related Oxidative Stress of Myocardial Infarction Patients. 2021;13:165–71. 19. Trentini A, Rosta V, Spadaro S, Bellini T, Rizzo P, Vieceli Dalla Sega F, et al. Development, optimization and validation of an absolute specific assay for active myeloperoxidase (MPO) and its application in a clinical context: Role of MPO specific activity in coronary artery disease. Clin Chem Lab Med. 2020; 20. Sawada N, Obama T, Koba S, Takaki T, Iwamoto S. Circulating oxidized LDL , increased in patients with acute myocardial infarction , is accompanied by heavily modified HDL. J Lipid Res [Internet]. 2020;61(6):816–29. Available from: http://dx.doi.org/10.1194/jlr.RA119000312 21. Itabe H, Sawada N, Makiyama T, Obama T. Structure and dynamics of oxidized lipoproteins in vivo: Roles of high‐density lipoprotein. Biomedicines. 2021;9. 22. Lorenzon J, Quadros AS De, Weschenfelder C, Garofallo SB, Marcadenti A. Oxidative Stress Biomarkers, Nut-Related Antioxidants, and Cardiovascular Disease. 2020;(Cvd):1–15. 23. Moll J, Fogoros RN. The Causes and Effects of Oxidized LDL Cholesterol. Verywell Heal [Internet]. 2020;1–6. Available from: https://www.verywellhealth.com/what-is-oxidized-ldl-698079.
24. Vasilyev VB, Sokolov A V., Kostevich VA, Elizarova AY, Gorbunov NP, Panasenko OM. Binding of lactoferrin to the surface of low-density lipoproteins modified by myeloperoxidase prevents intracellular cholesterol accumulation by human blood monocytes. Biochem Cell Biol. 2020;1–22. 25. John M, Priyanka S, George JB, Maria E, Unni G. Oxidative stress parameters in atherosclerotic cardiovascular disease high and low risk score groups as indicators for acute myocardial infarction. 2021;10:1–7. 26. Matuz-mares D, Riveros-rosas H. Glutathione Participation in the Prevention of Cardiovascular Diseases. 2021; 27. Li Z, Zhang J, Li Y, Zhao S, Zhang P, Zhang Y, et al. Carbon dots based photoelectrochemical sensors for ultrasensitive detection of glutathione and its applications in probing of myocardial infarction. Biosens Bioelectron [Internet]. 2018;99:251–8. Available from: http://dx.doi.org/10.1016/j.bios.2017.07.065 28. Nowak RM, Christenson RH, Jacobsen G, McCord J, Apple FS, Singer AJ, et al. Performance of Novel High-Sensitivity Cardiac Troponin I Assays for 0/1-Hour and 0/2- to 3-Hour Evaluations for Acute Myocardial Infarction: Results From the HIGH-US Study. Ann Emerg Med [Internet]. 2020;76:1–13. Available from: https://doi.org/10.1016/j.annemergmed.2019.12.008 29. Welsh P, Preiss D, Hayward C, Shah ASV, McAllister D, Briggs A, et al. Cardiac Troponin T and Troponin i in the General Population: Comparing and Contrasting Their Genetic Determinants and Associations with Outcomes. Circulation. 2019;139:2754–64. 30. McDonaugh B, Whyte M. The Evolution and Future Direction of The Cardiac Biomarker. EMJ Cardiol. 2020;97–106. 31. Khan DA, Sharif MS, Khan FA. Diagnostic performance of high-sensitivity troponin T,myeloperoxidase,and pregnancy-associated plasma protein a assays for triage of patients with acute myocardial infarction. Korean J Lab Med. 2011;31:172–78. 32. Omran MM, Zahran FM, Kadry M, Belal AAM, Emran TM. Role of myeloperoxidase in early diagnosis of acute myocardial infarction in patients admitted with chest pain. J Immunoass Immunochem [Internet]. 2018;39:337–47. Available from: https://doi.org/10.1080/15321819.2018.1492423 33. Liu C, Xie G, Huang W, Yang Y, Li P, Tu Z. Elevated serum myeloperoxidase activities are significantly associated with the prevalence of ACS and high LDL-C levels in CHD patients. J Atheroscler Thromb. 2012;19:435–43. 34. Sawicki M, Sypniewska G, Kozinski M, Gruszka M, Krintus M, Obonska K, et al. Diagnostic efficacy of myeloperoxidase for the detection of acute coronary syndromes. Eur J Clin Invest. 2011;41:667–71. 35. Meisinger C, Baumert J, Khuseyinova N, Loewel H, Koenig W. Plasma oxidized low-density lipoprotein, a strong predictor for acute coronary heart disease events in apparently healthy, middle-aged men from the general population. Circulation. 2005;112:651–57.
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