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. 2014 Feb;232(2):377-83.
doi: 10.1016/j.atherosclerosis.2013.11.075. Epub 2013 Dec 19.

Myeloperoxidase levels predict accelerated progression of coronary atherosclerosis in diabetic patients: insights from intravascular ultrasound

Yu Kataoka  1 , Mingyuan Shao  2 , Kathy Wolski  2 , Kiyoko Uno  2 , Rishi Puri  2 , E Murat Tuzcu  2 , Stanley L Hazen  3 , Steven E Nissen  2 , Stephen J Nicholls  2
Affiliations

Myeloperoxidase levels predict accelerated progression of coronary atherosclerosis in diabetic patients: insights from intravascular ultrasound

Yu Kataoka et al. Atherosclerosis. 2014 Feb.

Abstract

Objective: While inflammation has been proposed to contribute to the adverse cardiovascular outcome in diabetic patients, the specific pathways involved have not been elucidated. The leukocyte derived product, myeloperoxidase (MPO), has been implicated in all stages of atherosclerosis. The relationship between MPO and accelerated disease progression observed in diabetic patients has not been studied.

Methods: We investigated the relationship between MPO and disease progression in diabetic patients. 881 patients with angiographic coronary artery disease underwent serial evaluation of atherosclerotic burden with intravascular ultrasound. Disease progression in diabetic (n = 199) and non-diabetic (n = 682) patients, stratified by baseline MPO levels was investigated.

Results: MPO levels were similar in patients with and without diabetes (1362 vs. 1255 pmol/L, p = 0.43). No relationship was observed between increasing quartiles of MPO and either baseline (p = 0.81) or serial changes (p = 0.43) in levels of percent atheroma volume (PAV) in non-diabetic patients. In contrast, increasing MPO quartiles were associated with accelerated PAV progression in diabetic patients (p = 0.03). While optimal control of lipid and the use of high-dose statin were associated with less disease progression, a greater benefit was observed in diabetic patients with lower compared with higher MPO levels at baseline.

Conclusions: Increasing MPO levels are associated with greater progression of atherosclerosis in diabetic patients. This finding indicates the potential importance of MPO pathways in diabetic cardiovascular disease.

Keywords: Atheroma progression; CAD; Coronary atherosclerosis; DM; Diabetes mellitus; EEM; HDL; IVUS; Intravascular ultrasound; LDL; MPO; Myeloperoxidase; PAV; coronary artery disease; diabetes mellitus; external elastic membrane; high sensitivity C-reactive protein; high-density lipoprotein; hsCRP; intravascular ultrasound; low-density lipoprotein; myeloperoxidase; percent atheroma volume.

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Conflict of interest statement

Conflict of Interest

All other authors have reported that they have no relationships to disclose.

Figures

Figure 1
Figure 1. Atheroma Progression in Non-diabetic and Diabetic Patients
(a) Unadjusted changes in PAV in non-diabetic and diabetic patients stratified according to the quartiles of baseline MPO levels Left panel: before adjustments for baseline and change in LDL-C, diastolic blood pressure and concomitant insulin use in non-diabetic patients Right panel: before adjustments for baseline and change in LDL-C, diastolic blood pressure and concomitant insulin use in diabetic patients (b) Adjusted changes in PAV in diabetic patients stratified according to the quartiles of baseline MPO levels Change in PAV is shown in least-square mean. LDL-C = low-density lipoprotein cholesterol, MPO = myeloperoxidase, PAV = percent atheroma volume
Figure 2
Figure 2. LDL-C Control, High-dose Statin Therapy and Atheroma Progression in Diabetic Patients
Changes in PAV in diabetic patients with baseline low or high MPO level Left panel: stratified according to on-treatment levels of low-density lipoprotein cholesterol (LDL-C) < or ≥80mg/dl Right panel: stratified according to low or high dose statin use at follow-up. Change in PAV is shown in least-square mean. LDL-C = low-density lipoprotein cholesterol, MPO = myeloperoxidase, PAV = percent atheroma volume
See this image and copyright information in PMC

References

    1. Huxley R, Barzi F, Woodward M. Excess risk of fatal coronary heart disease associated with diabetes in men and women: meta-analysis of 37 prospective cohort studies. BMJ. 2006;332:73–78. - PMC - PubMed
    1. Ho JE, Paultre F, Mosca L. Women’s Pooling Project. Is diabetes mellitus a cardiovascular disease risk equivalent for fatal stroke in women? Data from the Women’s Pooling Project. Stroke. 2003;34:2812–2816. - PubMed
    1. Nicholls SJ, Tuzcu EM, Kalidindi S, Wolski K, Moon KW, Siphai I, Schoenhagen P, Nissen SE. Effect of diabetes on progression of coronary atherosclerosis and arterial remodeling: a pooled analysis of 5 intravascular ultrasound trials. J Am Coll Cardiol. 2008;52:255–262. - PubMed
    1. Stamler J, Vaccaro O, Neaton JD, Wentworth D. Diabetes, other risk factors, and 12-yr cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial. Diabetes Care. 1993;16:434–444. - PubMed
    1. Duncan BB, Schmidt MI, Pankow JS, Ballantyne CM, Couper D, Vigo A, Hoogeveen R, Folsom AR, Heiss G. Atherosclerosis Risk in Communities Study. Low-grade systemic inflammation and the development of type 2 diabetes: the atherosclerosis risk in communities study. Diabetes. 2003;52:1799–1805. - PubMed

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