Prognostic value of tissue inhibitor of metalloproteinase-1 for cardiovascular death among patients with cardiovascular disease: results from the AtheroGene study.
OBJECTIVE
Metalloproteinases are proteolytic enzymes, which decompose the extracellular matrix, influence cardiac remodelling, and are inhibited by tissue inhibitor of metalloproteinases (TIMPs). Little is known about the prognostic impact of the TIMP-1/matrix metalloproteinase complex in patients with future cardiovascular death.


RESULTS
In 1979 patients with suspected coronary artery disease (CAD), TIMP-1 has been determined at baseline. Among 1945 (98.4%) patients with a mean follow-up period of 2.6+/-1.2 years, 75 patients died because of cardiovascular causes. Mean concentrations of TIMP-1 were higher among patients who experienced a fatal cardiovascular event than among those who did not (820 vs. 692 ng/mL; P<0.001). Age and sex adjusted hazard ratio of future cardiovascular death associated with one standard deviation of TIMP-1 level, was 1.37 (95% CI: 1.17-1.61; P<0.001). The hazard ratio remained nearly identical after adjustment for clinical and therapeutic confounders. B-type natriuretic peptide (2.75, 95% CI: 1.94-3.89; P<0.001), C-reactive protein (1.79, 95% CI: 1.43-2.24; P<0.001), and TIMP-1 (1.30, 95% CI: 1.07-1.58; P=0.008) were independently associated with future cardiovascular death.


CONCLUSIONS
In patients with CAD, TIMP-1 proves as an independent predictor for future cardiovascular death.
Lubos
Edith
E
Department of Medicine II, Johannes Gutenberg-University, Langenbeckstrasse 1, 55101 Mainz, Germany. edithlubos@gmx.de
Schnabel
Renate
R
Rupprecht
Hans J
HJ
Bickel
Christoph
C
Messow
Claudia M
CM
Prigge
Susanne
S
Cambien
François
F
Tiret
Laurence
L
Münzel
Thomas
T
Blankenberg
Stefan
S
D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000201:enzymology* / Q000401:mortality; D003324:Coronary Artery Disease / Q000201:enzymology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000097:blood*
D015415:Biomarkers; D019715:Tissue Inhibitor of Metalloproteinase-1