Combined non-invasive scan and biomarkers to identify independent risk factors in patients with mild coronary stenosis

Independent risk factors for major adverse cardiovascular events (MACEs) in patients with mild coronary stenosis are uncertain. This study aims to investigate predictive biomarkers for MACEs in patients with mild coronary stenosis. Totally 381 patients with mild coronary stenosis were included and MACE incidences were recorded through a 24-month follow-up and 91 patients with unfavorable plaques characteristic are detected by CCTA. One unfavorable characteristic was recorded for 1 point and they were divided into three groups: high-risk group (HR, score =0), intermediate-risk group (IR, score =1) and low-risk group (LR, score/2). Specific blood biomarker measurements of high-sensitivity C-reactive protein (hs-CRP), matrix metallopeptidase 9 (MMP-9), and myeloperoxidase (MPO) were taken simultaneously. The mean age, hs-CRP and MPO levels in the HR and IR group were significantly higher than that in the LR group. A considerably higher level of MMP-9 showed in the HR group compared to the LR group. The incidence rates of MACE were remarkably higher in HR group than LR group and IR group. Kaplan-Meier survival analysis demonstrated that the cumulative event-free survival rate of HR was significantly higher than that in LR and IR group and there was no significant difference between LR and IR group. The univariate COX regression analysis indicated that the age, hs-CRP, MPO, and unfavorable plaque scores ≥2 were independent risk factors for MACEs. High MPO levels were strongly correlated with MACEs in patients with mild coronary stenosis. Although confirmation is needed from larger trials, MPO could be a promising clinical tool to improve the risk stratification in patients with mild coronary stenosis and suggest strategies for the individualized prevention programs.