Plasma matrix metalloproteinase-9 and ACE-inhibitor-induced improvement of urinary albumin excretion in non-diabetic, microalbuminuric subjects.
BACKGROUND
Elevated plasma matrix metalloproteinase-9 (MMP-9) levels have been suggested to precede the development of microalbuminuria. As angiotensin-converting enzyme (ACE) inhibitors effectively reduce urinary albumin excretion (UAE), in the present study we have investigated the potential association of plasma MMP-9 levels with UAE and treatment effects of ACE-inhibition.


METHODS
In a placebo-controlled randomised trial we determined plasma MMP-9 levels at baseline and after three months of randomisation to either placebo (n=202) or fosinopril (20 mg/day, n=204) treatment.


RESULTS
Baseline plasma MMP-9 levels were not related to baseline UAE (r=-0.008, p=0.871). Three months of fosinopril treatment effectively reduced UAE compared to placebo treatment (-10.4+/-2.4 vs. 1.8+/-1.3 mg/24 hours, p<0.001, respectively). However, fosinopril treatment failed to significantly change plasma MMP-9 levels compared to placebo (-0.47+/-7.68 vs. 0.06+/-9.20, p=0.646, respectively). In addition, the change in UAE was not related with change in MMP-9 levels.


CONCLUSIONS
The effective reduction of UAE with fosinopril was not related to plasma MMP-9 levels.
van de Wal
Ruud M A
RM
St Antonius Hospital, Department of Cardiology, Koekoekslaan 1, Nieuwegein, The Netherlands.
van der Harst
Pim
P
Gerritsen
Wim B M
WB
van der Horst
Fal
F
Plokker
Thijs H W
TH
Gansevoort
Ron T
RT
van Gilst
Wiek H
WH
Voors
Adriaan A
AA
D000419:Albuminuria / Q000097:blood* / Q000188:drug therapy*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D003920:Diabetes Mellitus / Q000097:blood*; D005260:Female; D017328:Fosinopril / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood*; D008875:Middle Aged; D010919:Placebos
D000806:Angiotensin-Converting Enzyme Inhibitors; D010919:Placebos; D020780:Matrix Metalloproteinase 9; D017328:Fosinopril