Elsevier

American Heart Journal

Volume 141, Issue 2, February 2001, Pages 211-217
American Heart Journal

Acute Ischemic Heart Disease
Plasma levels of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 are increased in the coronary circulation in patients with acute coronary syndrome*

https://doi.org/10.1067/mhj.2001.112238Get rights and content

Abstract

Background Previous studies on atherectomy specimens from patients with acute coronary syndrome (ACS) implicated the role of proteolytic enzymes. We examined whether the plasma levels of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) were increased in the coronary circulation in ACS. Methods and Results The plasma levels (nanograms per milliliter) of MMP-9 and TIMP-1 in the aorta (Ao) and great cardiac vein (GCV) were measured in 29 patients with ACS (20 with acute myocardial infarction [group 1] and 9 with unstable angina [group 2]), 17 with stable effort angina (group 3), and 20 control subjects (group 4). Group 1 patients had occlusion in the left anterior descending artery (LAD), and groups 2 and 3 patients had culprit lesion in the LAD. In group 1 blood samples were obtained at the time of direct coronary angioplasty done within 12 hours after the onset. The Ao level of either MMP-9 or TIMP-1 did not differ among the 4 groups. The GCV-Ao differences in MMP-9 and TIMP-1 were both significantly increased in groups 1 and 2 compared with those in group 4. Neither of them was different between groups 3 and 4. Neither the GCV-Ao difference in MMP-9 or TIMP-1 level was correlated with the maximal creatine kinase level in group 1. Conclusions Increased plasma levels of MMP-9 and TIMP-1 were detected in the coronary circulation in ACS patients, suggesting a process of active plaque rupture in ACS. (Am Heart J 2001;141:211-7.)

Section snippets

Study patients

Four groups of patients were included in this study. Group 1 consisted of 20 patients with anterior AMI (15 men and 5 women with a mean age of 65 years, ranging from 40 to 77 years). All these patients were admitted to our institution within 12 hours after the onset of AMI, and coronary angiography performed immediately after admission (average 6.6 ± 3.0 hours after onset, mean ± SD) revealed total occlusion in the LAD (12 patients) or subtotal occlusion in the LAD with a flow grade of 1 or 2

Clinical characteristics of the study groups

Table I shows the clinical characteristics of the 4 study group patients.

. Clinical profiles of study patients

Empty CellGroup 1Group 2Group 3Group 4Statistical significance
No.2091720
Age (y)65 ± 266 ± 264 ± 262 ± 3NS
Sex (male/female)15:57:213:414:6NS
Smoking11/20 (55%)7/9 (78%)9/17 (53%)6/20 (30%)NS
Diabetes mellitus11/20 (55%)4/9 (44%)10/17 (59%)2/20 (10%)P =.0079
Hypertension (>140/90 mm Hg)8/20 (40%)5/9 (56%)9/17 (53%)7/20 (35%)NS
Total cholesterol (mg/dL)193 ± 8186 ± 16199 ± 10201 ± 8NS
Triglycerides (mg/dL)

Discussion

By sampling blood simultaneously from the aortic root and great cardiac vein, the current study showed that the great cardiac vein–aortic root differences in plasma MMP-9 and TIMP-1 levels in patients with ACS were both significantly higher than those in patients with SEA and control subjects with normal coronary arteries. Neither of the great cardiac vein–aortic root differences in the MMP-9 level nor that in the TIMP-1 level was correlated with any of the maximal creatine phosphokinase and

Acknowledgements

We thank Drs Y. Fujino, T. Miura, and T. Osanai for their help and comments on the current study.

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    *

    Reprint requests: Ken Okumura, MD, Second Department of Internal Medicine, Hirosaki University School of Medicine, Zaifu-cho 5, Hirosaki 036-8562, Japan.E-mail: [email protected]

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