Myeloperoxidase levels are not associated with carotid atherosclerosis progression in patients with familial hypercholesterolemia

Introduction
myeloperoxidase (MPO), an antimicrobial enzyme of the innate immune system, has been proposed to exert a wide array of pro-atherogenic effects throughout all stages of the atherosclerotic process. In view of the potent anti-inflammatory effects of statins in vitro, we evaluated the impact of statin therapy on plasma MPO levels in patients with heterozygous familial hypercholesterolemia (FH), treated with either intensive or conventional lipid-lowering therapy. Furthermore, we evaluated the relation between myeloperoxidase (MPO)levels and atherosclerosis progression, as determined by intima media thickness (IMT).

Methods
We measured plasma MPO levels, lipoprotein profiles, high sensitivity-C-reactive protein (hs-CRP) as well as IMT of carotid artery segments in 122 FH patients at baseline and after 2-year treatment with atorvastatin 80mg or simvastatin 40mg QD.

Results
Baseline median myeloperoxidase (MPO)values were 147pM (interquartile range (IQR) 122–217) and 144pM (IQR 118–216) and these increased significantly to 221pM (IQR 144–290) and 255pM (IQR 152–324) during 2-year follow-up in both the atorvastatin 80mg and simvastatin 40mg group, respectively. There was no correlation between MPO levels and IMT progression, change in lipoproteins or hs-CRP.

Conclusion
In FH patients, statins do not prevent an increase in MPO levels during follow-up. Moreover, MPO levels are not associated with atherosclerosis progression in these patients.