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Renliang Zhang, MD,PhD; Marie-Luise Brennan, PhD; Xiaoming Fu, MS; Ronnier J. Aviles, MD; Gregory L. Pearce, MS; Marc S. Penn, MD,PhD; Eric J. Topol, MD; Dennis L. Sprecher, MD; Stanley L. Hazen, MD,PhD

JAMA. 2001;286:2136-2142.

Context  Myeloperoxidase (MPO), a leukocyte enzyme that promotes oxidation of lipoproteins in atheroma, has been proposed as a possible mediator of atherosclerosis.

Objective  To determine the association between MPO levels and prevalence of coronary artery disease (CAD).

Design, Setting, and Patients  Case-control study conducted from July to September 2000 in a US tertiary care referral center, including 158 patients with established CAD (cases) and 175 patients without angiographically significant CAD (controls).

Main Outcome Measures  Association of MPO levels per milligram of neutrophil protein (leukocyte-MPO) and MPO levels per milliliter of blood (blood-MPO) with CAD risk.

Results  Leukocyte- and blood-MPO levels were both significantly greater in patients with CAD than in controls (P<.001). In multivariable models adjusting for traditional cardiovascular risk factors, Framingham risk score, and white blood cell counts, MPO levels were significantly associated with presence of CAD, with an OR of 11.9 (95% CI, 5.5-25.5) for the highest vs lowest quartiles of leukocyte-MPO and an OR of 20.4 (95% CI, 8.9-47.2) for the highest vs lowest quartiles of blood-MPO.

Conclusions  Elevated levels of leukocyte- and blood-MPO are associated with the presence of CAD. These findings support a potential role for MPO as an inflammatory marker in CAD and may have implications for atherosclerosis diagnosis and risk assessment.

Author Affiliations: Department of Cell Biology (Drs Zhang, Brennan, Penn, Sprecher, and Hazen and Ms Fu), Section of Preventive Cardiology (Drs Sprecher, and Hazen and Mr Pearce), Department of Cardiology (Drs Aviles, Penn, Topol, Sprecher, and Hazen), and the Center for Cardiovascular Diagnostics and Prevention (Drs Zhang, Brennan, Penn, Topol, Sprecher, and Hazen), Cleveland Clinic Foundation, Cleveland, Ohio.

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