Predictive value of plasma myeloperoxidase level for malignant arrhythmia in elderly patients with valvular heart disease / 中国医师进修杂志

ABSTRACT

Objective:To investigate the predictive value of plasma myeloperoxidase (MPO) level for malignant arrhythmia (MA) in elderly patients with valvular heart disease.Methods:The clinical data of 92 elderly patients with valvular heart disease (valvular heart disease group) who underwent valve replacement surgery in Honghu People ′s Hospital in Hubei Province from May 2019 to May 2020 were retrospectively analyzed. The plasma MPO and serum N-terminal brain natriuretic peptide (NT-proBNP), lipoprotein a were detected and compared with those of 60 healthy examination people (healthy control group) during the same period. The independent risk factors of MA in elderly patients with valvular heart disease were analyzed by multivariate Logistic regression analysis method. Predictive value of MPO, NT-proBNP and lipoprotein a for MA in elderly patients with valvular heart disease were analyzed by receiver operating characteristic (ROC) curve. Results:The MPO, NT-proBNP and lipoprotein a in valvular heart disease group were significantly higher than those in healthy control group (128.36 ± 39.25) mg/L vs. (89.16 ± 26.09) mg/L, (698.97 ± 154.65) ng/L vs. (47.95 ± 9.05) ng/L and (315.82 ± 79.96) mg/L vs. (153.37 ± 42.38) mg/L, and there were statistical differences ( P<0.01). The 92 elderly patients with valvular heart disease were followed up for 1 year. MA occurred in 36 cases (MA subgroup), and MA did not occur in 56 cases (non-MA subgroup). The MPO, NT-proBNP and lipoprotein a in MA subgroup were significantly higher than those in non-MA subgroup (163.37 ± 29.11) mg/L vs. (105.86 ± 26.32) mg/L, (797.79 ± 113.54) ng/L vs. (635.45 ± 144.45) ng/L and (369.86 ± 45.27) mg/L vs. (281.08 ± 78.32) mg/L, and there were statistical differences ( P<0.01). Multivariate Logistic regression analysis result showed that the MPO, NT-proBNP and lipoprotein a were independent risk factors for MA in elderly patients with valvular heart disease ( OR = 0.937, 0.994 and 0.982; 95% CI 0.904 to 0.972, 0.988 to 0.999 and 0.968 to 0.996; P<0.01 or <0.05). ROC curve analysis result showed that the area under the curve of MPO for predicting MA in elderly patients with valvular heart disease was significantly greater than that of NT-proBNP and lipoprotein a (0.934 vs. 0.813 and 0.830, Z = 2.441 and 2.299, P<0.05). Conclusions:Plasma MPO is abnormally elevated in elderly patients with valvular heart disease, which has a good predictive value for the occurrence of postoperative MA in elderly patients with valvular heart disease.