title: Comparison of levels of serum matrix metalloproteinase-9 in patients with acute myocardial infarction versus unstable angina pectoris versus stable angina pectoris.
abstract: Matrix metalloproteinases (MMPs) are important for resorption of extracellular matrixes and may degrade the fibrous cap of an atherosclerotic plaque, thus contributing to coronary plaque rupture. Histologic studies have shown MMP expression in lesions of acute coronary syndrome. In this study, we evaluated the relation between plaque morphology as obtained by intravascular ultrasound before percutaneous coronary intervention and serum MMP levels in patients who had coronary artery disease. We enrolled consecutive 47 patients who had acute myocardial infarction (AMI), 23 who had unstable angina pectoris (UAP), and 19 who had stable effort angina pectoris and underwent intravascular ultrasound before percutaneous coronary intervention followed by successful primary percutaneous coronary intervention. Peripheral blood was obtained from all patients before angiography and serum levels of MMP-1,-2, and -9 were analyzed. Serum levels of MMP-9 in the AMI and UAP groups were significantly higher than that in the stable effort angina pectoris group (p = 0.007 and 0.04, respectively). From the intravascular ultrasound findings before percutaneous coronary intervention, plaque rupture was detected in 26 patients (55%) in the AMI group and in 11 patients (48%) in the UAP group. In these 2 groups, patients with plaque rupture had significantly higher levels of MMP-9 than patients who did not have plaque rupture (p = 0.03 and 0.01, respectively). Multiple logistic regression analysis showed that MMP-9 was the only independent predictor of plaque rupture (p = 0.004). In conclusion, high levels of MMP-9 in patients who have AMI and UAP are related to the presence of plaque rupture in the culprit lesion.
authors.affiliation: Department of Internal Medicine, Cardiology Graduate School of Medicine, Osaka City University Medical School, Osaka, Japan. daiju@qg7.so-net.ne.jp
authors.forename: Daiju
authors.initials: D
authors.lastname: Fukuda
authors.forename: Kenei
authors.initials: K
authors.lastname: Shimada
authors.forename: Atsushi
authors.initials: A
authors.lastname: Tanaka
authors.forename: Takanori
authors.initials: T
authors.lastname: Kusuyama
authors.forename: Hajime
authors.initials: H
authors.lastname: Yamashita
authors.forename: Shoichi
authors.initials: S
authors.lastname: Ehara
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Takahiko
authors.initials: T
authors.lastname: Kawarabayashi
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Iida
authors.forename: Minoru
authors.initials: M
authors.lastname: Yoshiyama
authors.forename: Junichi
authors.initials: J
authors.lastname: Yoshikawa
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000097:blood*; D003324:Coronary Artery Disease / Q000097:blood / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood*; D018084:Ultrasonography, Interventional
chemical_list: D020780:Matrix Metalloproteinase 9