Predictive value of serum myeloperoxidase (MPO) concentration combined with triglyceride-glucose index (TyG) for major adverse cardiaovascular events (MACE) in patients with coronary heart disease

Abstract

Background

Coronary heart disease (CHD) remains a leading cause of mortality globally. The prognostic value of myeloperoxidase (MPO) and the triglyceride-glucose (TyG) index in predicting adverse cardiovascular events among individuals with CHD remains uncertain. This study aimed to investigate the predictive value of MPO in combination with the TyG index for major adverse cardiovascular events (MACE) in patients with CHD.

Method

A total of 731 patients with CHD admitted to the First Affiliated Hospital of Xinjiang Medical University between July 2022 and January 2024 were enrolled and analyzed. Patients were categorized based on median values of MPO and the TyG index. Subsequent follow-up was conducted to determine the occurrence of MACE within two years of hospital discharge. Multivariate logistic regression analysis was performed to assess the associations between MPO, the TyG index, and MACE. The area under the receiver operating characteristic (ROC) curve (AUC) was utilized to identify the most valuable predictor. Kaplan-Meier curve analysis was employed to examine the relationship between the predictor and prognosis.

Results

263 patients experienced MACE during a median follow-up of two years. Compared to patients with a lower TyG index (<8.44) and MPO (<417 ng/ml), those with a higher combined TyG index and MPO exhibited the highest risk of MACE. Multivariate logistic regression analysis demonstrated that both the TyG index and MPO level were significant predictors of MACE (p < 0.05), with MPO (Odds Ratio [OR] = 1.01, 95 % Confidence Interval [CI] 1.01–1.01) and the TyG index (OR = 2.80, 95 % CI 1.56–5.00) independently associated with increased MACE risk. Kaplan-Meier curves revealed a higher 2-year overall survival rate in CHD patients with lower serum MPO and TyG index levels. ROC curve analysis showed that the AUC for MACE associated with MPO was 0.71, while the AUC for MACE events linked to the TyG index was 0.67. The combined AUC was 0.71, indicating that MPO enhances the predictive efficacy of the TyG index for MACE in CHD patients (p < 0.05).

Conclusion

The TyG index and MPO exhibit a synergistic interaction in increasing the risk of MACE in patients with CHD. These findings underscore the importance of utilizing both measures concurrently when assessing cardiovascular risk in this population.