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The Association of Serum Neutrophil Markers and Acute Coronary Syndrome
Author(s) -
Alfakry Hatem,
Sinisalo Juha,
Paju Susanna,
Nieminen Markku S.,
Valtonen Ville,
Tervahartiala Taina,
Pussinen Pirkko J.,
Sorsa Timo
Publication year - 2012
Publication title -
scandinavian journal of immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.934
H-Index - 88
eISSN - 1365-3083
pISSN - 0300-9475
DOI - 10.1111/j.1365-3083.2012.02718.x
Subject(s) - medicine , acute coronary syndrome , gastroenterology , unstable angina , quartile , myeloperoxidase , clarithromycin , placebo , myocardial infarction , inflammation , confidence interval , pathology , alternative medicine , helicobacter pylori
An association exists between chronic infection‐induced inflammation, such as periodontitis, and acute coronary syndrome (ACS). We studied the association of serum neutrophil markers, myeloperoxidase (MPO), matrix metalloproteinase (MMP)‐8, tissue inhibitor of metalloproteinase (TIMP)‐1 concentrations and MMP‐8/TIMP‐1 ratio, with the risk of recurrent ACS. Radiographic periodontal status was recorded from 141 patients with acute non‐Q‐wave infarction or unstable angina pectoris, who participated in a double‐blind, placebo‐controlled study with clarithromycin for 3 months. Serum samples were collected within arrival to the hospital, at 1 week, 3 months and 1 year. Recurrent ACS events were registered during the 1‐year follow‐up. In the whole population, high serum MPO concentrations at 1 week (fourth quartile versus quartiles 1–3) were associated with the risk of recurrent ACS with a relative risk (RR) of 2.52 (95% CI, 1.277–4.980; P = 0.008). In patients without periodontal disease, high MPO concentration at 1 week and 1 year predicted recurrent ACS with RRs of 3.54 (1.600–7.831; P = 0.002) and 2.87 (1.171–7.038; P = 0.021), respectively. In the placebo group, but not in the clarithromycin group, high serum MMP‐8/TIMP‐1 ratio at 1 week predicted recurrent ACS with an RR of 3.23 (1.295–8.063; P = 0.012). Our results suggest that high serum neutrophil markers reflect increased risk of recurrent ACS, especially in patients without periodontal disease and not receiving antimicrobial medication.