Elevated plasma active matrix metalloproteinase-9 level is associated with coronary artery in-stent restenosis.
OBJECTIVE
This study aimed to determine whether the plasma levels of matrix metalloproteinase-9 (MMP-9) or tissue inhibitor of metalloproteinases-1 (TIMP-1) were altered in patients with a history of symptomatic in-stent restenosis (ISR).


RESULTS
A group of 158 patients with a history of ISR were compared with 128 symptom-free patients. Plasma samples and a detailed risk factor history were collected. Plasma samples were analyzed for pro-MMP-9 and latent MMP-9 and active MMP-9, latent MMP-3, and TIMP-1. Several variables were associated with ISR, including index coronary disease extent and severity (number of diseased vessels and American College of Cardiology/American Heart Association lesion classification), number, diameter, and total length of stent(s) inserted, and plasma high-density lipoprotein cholesterol. Plasma active MMP-9 (odds ratio, 1.96; 95% CI, 1.43 to 2.69) showed independent risk association with ISR. Patients with multiple sites of ISR had significantly higher levels of active MMP-9 compared with patients with only a single ISR lesion or no ISR.


CONCLUSIONS
Plasma active MMP-9 levels may be a useful independent predictor of bare metal stent ISR.
Jones
Gregory T
GT
Section of Surgery, University of Otago, Dunedin, New Zealand. greg.jones@otago.ac.nz
Kay
I Patrick
IP
Chu
J W S
JW
Wilkins
G T
GT
Phillips
L V
LV
McCormick
M
M
van Rij
A M
AM
Williams
M J A
MJ
D000368:Aged; D008076:Cholesterol, HDL / Q000097:blood; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000097:blood* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood*; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015607:Stents; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000097:blood*
D008076:Cholesterol, HDL; D019715:Tissue Inhibitor of Metalloproteinase-1; D020780:Matrix Metalloproteinase 9