Abstract 13516: Elevated Plasma Levels of Matrix Metalloproteinase 9 Are Associated with Sudden Cardiac Arrest in the General Population
Introduction: Severe LV dysfunction is the mainstay for selecting candidates for SCA primary prevention with the implantable defibrillator, but improved risk stratification methods are needed. Elevated plasma levels of matrix metalloproteinase 9 (MMP9) are associated with heart failure (HF) with preserved LV ejection fraction (EF) as well as worse prognosis in late stage HF, but a potential association with SCA has not been evaluated.
Hypothesis: Elevated MMP9 is a determinant of SCA in the community.
Methods: In an ongoing prospective, community-based study of SCA in Northwest US, we compared MMP9 levels in 145 adult cases of adjudicated SCA (age 64.1 ± 11.7 y, 73% male) and 149 controls with coronary artery disease (age 64.2 ± 11.6 y, 73% male). Plasma was obtained from blood drawn at the time of arrest (cases) and at a routine visit (controls), and analyzed using Quantikine Immunoassay (CV <3%, normal range for healthy controls 13-105 ng/ml). MMP9 levels were log transformed and compared (T-test and Chi-square test) per quartiles (based on controls). Logistic regression was used to predict the adjusted odds of SCA associated with MMP9 levels (per increase in quartile).
Results:MMP9 was significantly higher in SCA cases vs controls (354±269 vs 199±120 ng/ml, P<0.0001). There were no differences between the groups regarding age, gender or body mass index (all P>0.05). In a logistic regression model MMP9 remained an independent risk predictor of SCA (OR/increased quartile of MMP9 2.8, 95% CI 1.7-4.7, P<0.0001) after adjusting for age, gender, and LV dysfunction (Table).
Conclusions:Elevated circulating levels of MMP9 in plasma were associated with SCA in this community-based analysis. Further investigation is warranted into the potential role of this biomarker in SCA risk stratification.
- © 2012 by American Heart Association, Inc.