Abstract 14510: Time-dependent Changes in Matrix Metalloproteinase-9 at the Earliest Stage of ST Elevation Acute Coronary Syndrome: Comparison with Other Biomarkers
Background: Matrix metalloproteinase-9 (MMP-9) is regarded as a marker of plaque instability or rupture and elevates in the patients with acute coronary syndrome (ACS). Because plaque rupture precedes myocardial necrosis in ACS, it is hypothesized that the elevation of MMP-9 precedes that of myocardial necrosis markers.
Objective: To compare the time-dependent changes in MMP-9 with another plaque rupture marker (soluble lectin-like oxidized low-density lipoprotein receptor-1, sLOX-1) and cardiac necrosis markers (troponin T and heart-type fatty acid-binding protein, H-FABP) at the earliest stage of ST elevation-ACS (STE-ACS).
Methods and Results: Plasma MMP-9 levels were measured in 104 STE-ACS, 36 non-ST elevation ACS (NSTE-ACS) and 20 control population. As shown in figure 1, MMP-9 levels were significantly (p<0.001) higher in patients with STE-ACS and NSTE-ACS than control subjects (median, 25th and 75th percentiles: 120.0, 55.8 and 290.0 vs 71.5, 43.0 and 132.5 vs 32.0, 22.3 and 49.8 pg/mL, respectively). Time-dependent changes in MMP-9, sLOX-1, troponin T and H-FABP were analyzed in 27 STE-ACS patients (figure 2). MMP-9 and sLOX-1 had elevated yet at 126 ± 90 minutes from the symptom onset, whereas H-FABP and troponin T did not elevate at that time and peaked at ≥ 2 hours thereafter. There was a strong correlation between MMP-9 and sLOX-1 (Spearman ρ=0.739, p<0.001), whereas no correlation was found between MMP-9 and troponin T or H-FABP.
Conclusions: Plasma MMP-9 and sLOX-1 elevated earlier than H-FABP and troponin T at the early stages of STE-ACS reflecting plaque rupture or instability.
- © 2010 by American Heart Association, Inc.