264: Myeloperoxidase, hs CRP and endothelial dysfunction in cardiovascular risk assessment in diabetic and hypertensive patients

IntroductionSeveral inflammatory markers have been associated with a greater likelihood of cardiovascular diseases. Of those C-reactive protein (CRP) and myeloperoxidase (MPO) are the most well known.The development of sensitive rapid tests for MPO and hs-CRP, together with a simple hand-held reader promises to open up the possibility of identifying high-risk patients early enough for the introduction of prophylactic therapies or the adoption of beneficial life-style changes.ObjectivesWe propose to evaluate the cardiovascular risk for 50 hypertensive and diabetic patients by rapid tests for MPO and hs-CRP and to compare with endothelial function and Framingham score.ResultsWe evaluate prospectively 50 patients without cardiovascular events, the mean age is 53 years, 78% have mean or high CV risk according to the Framingham score and 38% presenting endothelial dysfunction.The statistical analysis showed a significant association between the rate of hs-CRP, the Framingham score (p=0,02, r=0,424), with the metabolic syndrome (p=0,0001), and endothelial dysfunction (p=0,001).MPO level is correlated with the sex (p=0,002), age (p=0,05), as well with the Framingham score (r=0,345), the metabolic syndrome (p=0,001), the endothelial dysfunction (p=0,001), and also with the LDL cholesterol. (p=0,04; r=0,3).In the same way, a significant Correlation was shown between hs-CRP and MPO (p=0,016; r=0,34).The hs-CRP test showed a good specificity (85%), and VPP (96%), a weak VPN (27%).However MPO test showed a low specificity (25%) low sensitivity (25%), VPP of (73%) and a low VPN (5%).ConclusionThe hs-CRP represents the inflammatory marker most relevant in the prediction of risk CV, better than the MPO.These markers reflect the clinical potential of atherothrombotic disease may allow more precise risk stratification and prognostication in high-risk populations, and perhaps earlier diagnosis and intervention in patients at risk for or with occult cardiovascular disease