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The activation of leukocytes prompts the secretion of myeloperoxidase (MPO) and the generation of oxidants. Several lines of evidence suggest that MPO secreted by leukocytes participates in atherosclerotic progression and contributes to plaque vulnerability. MPO has been linked to the development of lipid-laden soft plaque, the activation of protease cascades affecting the stability and thrombogenicity of plaque, the production of cytotoxic and prothrombogenic oxidized lipids, and the consumption of nitric oxide, leading to vasoconstriction. The plasma MPO concentration in patient samples acquired during the period of assessment for acute coronary syndrome in emergency departments predicts the risk of major adverse cardiac events: i.e., myocardial infarction, need for revascularization or death, over the next 30-day and 6-month interval. The odds ratio for adverse cardiac events increases with increasing levels of plasma MPO in all quartiles of the population. The predictive power of the MPO concentration is independent of age, gender, race, CRP level, Troponin T level, CK-MB level, history of diabetes, history of smoking, history of hyperlipidemia, or history of hypertension. Cayman |