Association of myeloperoxidase, homocysteine and high-sensitivity C-reactive protein with the severity of coronary artery disease and their diagnostic and prognostic value

In the present study, the association between the severity of coronary artery disease (CAD) and myeloperoxidase (MPO), homocysteine (Hcy) and high-sensitivity C-reactive protein (hs-CRP) was assessed and their diagnostic and prognostic value was determined. A total of 112 patients with CAD [patient group (PG)] and 112 healthy participants who visited the hospital for physical examinations [control group (CG)] were enrolled in the present study. The plasma levels of MPO, Hcy and hs-CRP were compared between the two groups. According to the arteriography results, the patients were further divided into the single-vessel disease group (SVG), double-vessel disease group (DVG) and multi-vessel disease group (MVG). The Gensini scores of the three groups were evaluated according to the Gensini score standard. The correlations between the expression of MPO, Hcy or hs-CRP and the Gensini score of the PG were analyzed. The patients' major adverse cardiovascular event (MACEs) were recorded over 6 months and compared, and the predictive values of MPO, Hcy and hs-CRP regarding MACEs were determined by receiver operating characteristics analysis. The results indicated that the levels of MPO, Hcy and hs-CRP in the PG were higher than those in the CG (P<0.05). The Gensini score and the expression of MPO, Hcy and hs-CRP in the MVG were higher than those in the SVG and the DVG, and the Gensini score and the expression of MPO, Hcy and hs-CRP in the DVG were higher than those in the SVG (P<0.05). There was a positive correlation between the Gensini score and the expression of MPO (r=0.814, P<0.05), Hcy (r=0.774, P<0.05) and hs-CRP (r=0.765, P<0.05) in the PG. The total incidence of MACEs in patients with multiple lesions was significantly higher than that in patients with double and single lesions (P<0.05). The total incidence of MACEs in the MVG group was higher than that in the SVG and the DVG, and the total incidence of MACEs in the DVG was higher than that in the SVG (P<0.05). The area under the curve (AUC) and sensitivity for MPO levels to predict MACEs were higher than those of Hcy and hs-CRP (P<0.05); however, there was no significant difference in the AUC and sensitivity of Hcy and hs-CRP for predicting MACEs (P<0.05). The specificity of hs-CRP for predicting MACEs was higher than that of MPO and Hcy (P<0.05). The number of lesions, hypertension, diabetes, MPO, Hys and hs-CRP were determined to be independent risk factors for MACEs. In conclusion, for patients with CAD, elevated plasma levels of MPO, Hcy and hs-CRP were directly correlated with the severity of CAD and the risk of MACEs. Furthermore, MPO, Hcy and hs-CRP may effectively predict MACEs and are of important clinical significance in terms of judging the condition and improving the prognosis for patients with CAD.