April 22, 2026Journal of the American College of Cardiology
Serum Myeloperoxidase Levels Are Associated With the Future Risk of Coronary Artery Disease in Apparently Healthy Individuals
Key result
Elevated serum myeloperoxidase is linked to ~49% higher risk of future CAD in healthy adults.
- OR 1.49
- 95% CI 1.20 to 1.84
- P<0.001
- n=3,375
Why the study?
Serum myeloperoxidase (MPO) levels may be associated with future risk of coronary artery disease (CAD) in apparently healthy individuals, but this relationship requires evaluation.
Do elevated baseline serum myeloperoxidase (MPO) levels predict the future risk of coronary artery disease in apparently healthy individuals?
Comparison
Elevated baseline serum MPO levels (top quartile) vs lower baseline serum MPO levels (bottom quartile)
Design
Case-control study nested in a prospective cohort
Follow-up
8 years
Authors
Discussion
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Implication
Should not yet change practice in primary prevention; leaves open MPO's role in refining CAD risk prediction beyond traditional factors.
Key Points
- To evaluate whether baseline serum myeloperoxidase (MPO) levels are associated with the future development of coronary artery disease (CAD) in apparently healthy individuals.
- Conducted a nested case-control study within the prospective EPIC-Norfolk cohort during an 8-year follow-up.
- Measured baseline serum MPO in 1,138 apparently healthy individuals who subsequently developed CAD and 2,237 controls matched for age, sex, and enrollment time who remained CAD-free.
- Future CAD risk rose across quartiles of baseline MPO concentration, with an unadjusted OR of 1.49 (95% CI 1.20 to 1.84; p < 0.001) and an adjusted OR of 1.36 (95% CI 1.07 to 1.73) for the top versus bottom quartile.
- Serum MPO levels correlated significantly with C-reactive protein (rho = 0.25; p < 0.001) and white blood cell count (rho = 0.33; p < 0.001).
- Elevated MPO levels (>728 pmol/l) independently predicted CAD risk in subgroups with LDL-cholesterol <130 mg/dl (OR 1.52, 95% CI 1.21 to 1.91), HDL-cholesterol >50 mg/dl (OR 1.59, 95% CI 1.24 to 2.05), or CRP <2.0 mg/l (OR 1.42, 95% CI 1.14 to 1.77).
Study Design
Type
Case-Control (n=3,375)
Structured PICO
Do elevated baseline serum myeloperoxidase (MPO) levels predict the future risk of coronary artery disease in apparently healthy individuals?
P
Population
3,375 apparently healthy men and women, comprising 1,138 who developed CAD and 2,237 matched controls, followed for 8 years.
E
Exposure
Elevated baseline serum myeloperoxidase (MPO) levels (top quartile)
C
Comparator
Lower baseline serum myeloperoxidase (MPO) levels (bottom quartile)
O
Outcome
Future development of coronary artery disease (CAD) during 8-year follow-uphard clinical
Main Result
Odds Ratio: 1.49 (95% CI 1.2–1.84)
p-value: p=<0.001
Elevated baseline serum myeloperoxidase levels independently predict the future risk of coronary artery disease in apparently healthy individuals, suggesting that inflammatory activation precedes overt CAD by many years.
Cite This Study
Meuwese et al. (2007) conducted a case-control in Coronary artery disease (n=3,375). Serum myeloperoxidase (MPO) levels vs. Bottom quartile of MPO concentration was evaluated on Future development of coronary artery disease (CAD) (OR 1.49, 95% CI 1.20 to 1.84, p=<0.001). Elevated serum myeloperoxidase levels were associated with an increased risk of future coronary artery disease in apparently healthy individuals (OR 1.49; 95% CI 1.20-1.84; p<0.001).