Abstract 12418: Usefulness of Plasma Matrix Metalloproteinase-9 Level in Predicting Future Coronary Revascularization in Patients After Acute Myocardial Infarction
Objectives: Matrix metalloproteinases (MMPs) have been implicated in development of atherosclerosis and plaque rupture in acute coronary syndrome (ACS). This study was aimed to investigate whether plasma levels of MMPs and inflammatory markers could predict long-term prognosis of coronary revascularization in patients after acute myocardial infarction (MI).
Methods: Ninety-six consecutive patients (63±11 years) diagnosed as having myocardial infarction were enrolled. All subjects were followed-up for 43±12 months. Plasma levels of MMP-2 and MMP-9 were determined from blood samples collected immediately after hospitalization. Coronary revascularization was defined as received percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG).
Results: A total of 29 cases (30%) received coronary revascularization occurred during follow-up period, including 27 PCI and 2 CABG. Baseline characteristics were similar between groups with or without revascularization. Patients with coronary revascularization had significantly higher MMP-9 levels (p=0.048), but not MMP-2. Additionally, a positive correlation was noted between circulating MMP-9 level and total cholesterol (r=0.250, p=0.016) and low density lipoprotein-cholesterol (LDL-C; r=0.284, p=0.009). All patients were divided into a high-MMP-9 group (highest tertile, ≥1.10 ng/ml) and a low-MMP-9 group (<1.10 ng/ml). The incidence of coronary revascularization was significantly increased in the high-MMP-9 group (p=0.034). In a multivariate Cox regression analysis that included MMP-9, and classical risk factors, MMP-9 level was an independent predictor of coronary revascularization in patients after AMI (Hazard ratio, 2.72 ; 95% CI, 1.24 to 5.98; P=0.026).
Conclusions: Increased plasma levels of MMP-9 but not MMP-2 predict future coronary revascularization, and an significant association was observed in MMP-9 and LDL-C. These findings suggest a pivotal role of MMP-9 in atherothrombosis in AMI patients.
- © 2012 by American Heart Association, Inc.