The balance of serum matrix metalloproteinase-8 and its tissue inhibitor in acute coronary syndrome and its recurrence

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:167

Article

Pussinen, Pirkko J.^1,2  Sarna, Seppo³  Puolakkainen, Mirja^4,5  Ohlin, Hans^6,7  Sorsa, Timo^1,2  Pesonen, Erkki^6,7 

[1] Univ Helsinki, Inst Dent, FI-00014 Helsinki, Finland

[2] Helsinki Univ Cent Hosp, Dept Oral & Maxillofacial Dis, FI-00014 Helsinki, Finland

[3] Univ Helsinki, Dept Publ Hlth, FI-00014 Helsinki, Finland

[4] Univ Helsinki, Haartman Inst, Dept Virol, FI-00014 Helsinki, Finland

[5] HUSLAB, FI-00014 Helsinki, Finland

[6] Skane Univ, Malmo, Sweden

[7] Skane Univ Hosp, Div Paediat Cardiol, Dept Paediat, SE-22100 Lund, Sweden

关键词: Acute coronary syndrome;    Acute myocardial infarction;    Unstable angina pectoris;    Inflammation;    Matrix metalloproteinase-8;    Tissue inhibitor of metalloproteinases-1;   

DOI  :  10.1016/j.ijcard.2011.12.095

来源: Elsevier

【 摘 要 】

Background: Matrix metalloproteinase-8 (MMP-8) is involved in the breakdown of the extracellular matrix increasing the vulnerability of atherosclerotic lesions. We analysed the diagnostic value of serum MMP-8 and tissue inhibitor of metalloproteinase-1 (TIMP-1) concentrations in acute coronary syndrome (ACS) and their prognostic value in ACS recurrence. Methods: The population comprised 343 patients with ACS [including 108 unstable angina pectoris and 235 acute myocardial infarctions (AMI)] and 326 healthy controls. Additionally, 157 (45.8%) patients were resampled during the recovery. The ACS patients were followed up for 6 years. Results: MMP-8, TIMP-1, and their molar ratio distinguished the cases from the controls; C-statistic of the multivariate model (95% CI, p-value) including the MMP-8/TIMP-1 ratio regarding its discriminating ability for AMI was 0.922 (0.893-0.950, p < 0.001). After the acute phase of ACS, median MMP-8 and TIMP-1 concentrations decreased (p < 0.001) by 34.5 and 28.7%, respectively, but ended up on a different level than those found in the controls. In the follow-up, acute phase and recovery period TIMP-1 concentrations associated with cardiovascular death with hazard ratios 4.31 (2.00-9.26, p < 0.001) and 4.69 (1.10-20.01, p = 0.037), respectively. Conclusions: The increase of serum MMP-8 and TIMP-1 concentrations may reflect plaque instability and tissue damage. TIMP-1 concentrations are associated with poor outcome in patients with ACS. The findings may have practical implications in both diagnostics and therapeutics. (c) 2011 Elsevier Ireland Ltd. All rights reserved.

【 授权许可】

Free