Myeloperoxidase

Myeloperoxidase (MPO), a member of the heme peroxidase superfamily, is a leukocyte-derived enzyme stored abundantly in the azurophilic granules of monocytes and neutrophils. MPO converts low-density lipoprotein (LDL) to atherogenic particles, and has therefore been implicated in having a significant role in the atherosclerotic process, which can lead to several life-threatening conditions, including coronary artery disease (CAD).^1,2

Clinical Applications

With the identification of inflammation as a key contributor to atherosclerosis and atherothrombosis, MPO is used as a marker to evaluate patients with cardiovascular diseases.⁴

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MPO in Acute Coronary Syndrome (ACS) and Heart Failure (HF)*

Elevated plasma MPO levels predict:

Adverse outcomes in patients with chest pain or suspected ACS, and in chronic heart failure^*2,4
Enhanced likelihood of more advanced HF in patients with chronic systolic HF^*4

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MPO in Plaque Instability and Inflammation

MPO is an emerging marker for inflammation and plaque instability:

MPO damages lipids and proteins in the vascular wall by releasing reactive intermediates, contributing to atherogenesis.¹
MPO produces a wide range of proatherogenic effects that include induction of oxidative damage to HDL and LDL, and enhancement of plaque vulnerability.⁴
By stimulating tissue factor expression, inducing endothelial apoptosis, and activating metalloproteinases, MPO may contribute to atherosclerotic plaque destabilization, which eventually results in plaque rupture and myocardial infarction.
MPO can be used to indicate processes that are not detected using traditional tools for risk stratification in patients without active inflammatory or infectious conditions.*

MPO in Coronary Artery Disease*

Elevated MPO levels predict future risk for CAD in apparently healthy individuals and low risk groups, such as those with near-optimal levels of low-density lipoprotein and high levels of high-density lipoprotein (HDL).²
A significant elevation of MPO is found in patients undergoing coronary artery stenting, especially in the unstable angina group.⁵
Although elevated plasma MPO is associated with an advanced cardiovascular risk profile in patients with stable CAD, it fails to predict the mortality independent of other cardiovascular risk factors.⁶

Reliable Answers to Critical Cardiac Questions

Siemens Healthcare Diagnostics offers MPO testing across multiple instrument solutions to help provide a more complete clinical picture of the CVD patient.

Learn more

Myeloperoxidase assays are available on the following systems from Siemens Healthcare Diagnostics:

Integrated Systems

Dimension® RxL Max®
Dimension® Xpand Plus

Click here to learn more about our complete menu of cardiac biomarkers.

^{*Siemens Healthcare Diagnostics’ MPO assay does not currently have claims for this specific application. Please refer to our IFU for specific intended use claims for this assay.}

^{References:

1. Daugherty A, et al. J Clin Invest. 1994;94:437-44. http://www.ncbi.nlm.nih.gov/pubmed/8040285

2. Meuwese MC, et al. J Am Coll Cardiol. 2007;50:159-65. http://www.ncbi.nlm.nih.gov/pubmed/17616301?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Disco veryPanel.Pubmed_Discovery_RA&linkpos=1&log$=relatedarticles&logdbfrom=pubmed

3. Dimension® Clinical Chemistry Systems MPO Flex® reagent cartridge IFU. 2009-01-22; E, PN 755425.001 - US

4. Tang WH, et al. J Am Coll Cardiol. 2007 19;49:2364-70. http://www.ncbi.nlm.nih.gov/pubmed/17572253?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Disco veryPanel.pubmed_Discovery_RA&linkpos=1&log$=relatedarticles&logdbfrom=pubmed

5. Gach O, et al. Int J Cardiol. 2006;112:59-65. http://www.ncbi.nlm.nih.gov/pubmed/16316691?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Disco veryPanel.Pubmed_Discovery_RA&linkpos=1&log$=relatedarticles&logdbfrom=pubmed

6. Stefanescu A, et al. Am Heart J. 2008;155:356-60. http://www.ncbi.nlm.nih.gov/pubmed/18215608?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Disco veryPanel.Pubmed_Discovery_RA&linkpos=1&log$=relatedarticles&logdbfrom=pubmed

7. Morrow DA, et al. Eur Heart J. 2008;29:1096-102. http://www.ncbi.nlm.nih.gov/pubmed/18339606?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Disco veryPanel.Pubmed_Discovery_RA&linkpos=2&log$=relatedarticles&logdbfrom=pubmed}