title: Circulating stromelysin-1 (MMP-3): a novel predictor of LV dysfunction, remodelling and all-cause mortality after acute myocardial infarction.
abstract: BACKGROUND
  Changes to cardiac matrix are central to ventricular remodelling after acute MI and matrix metalloproteinase expression is implicated in this process. We investigated the temporal profile of MMP-3 and its relationship to LV dysfunction and prognosis following AMI.
  
  
  METHODS
  We studied 382 patients with AMI. Plasma MMP-3 was measured at 0-12, 12-24 h and for subsequent 24 h periods during admission. LV function (LVEF) was assessed by echocardiography pre-discharge and at a median of 148 days and clinical endpoints at a median of 313 days.
  
  
  RESULTS
  MMP-3 peaked prior to discharge thus pre-discharge levels were used in analyses. MMP-3 was associated with patient age (p<0.001), creatinine (p<0.001) and was higher in males (p<0.001) and hypertensives (p<0.001). MMP-3 inversely correlated with LVEF at follow-up (p=0.043), was higher in subjects with LVEF <40% (p=0.017) and in subjects with increasing EDV (p=0.017) or ESV (p=0.007) compared to those in whom volumes fell between visits. In the 58 patients reaching the endpoint of death or heart failure, MMP-3 was higher (p<0.001). On Kaplan-Meier analysis, subjects with levels above optimum cut off identified via ROC curves were more likely to suffer a clinical event (p=0.037).
  
  
  CONCLUSIONS
  MMP-3 is associated with left ventricular dysfunction, adverse left ventricular remodelling and prognosis after AMI.
authors.affiliation: Department of Cardiovascular Sciences, University of Leicester, UK.
authors.forename: D
authors.initials: D
authors.lastname: Kelly
authors.forename: S
authors.initials: S
authors.lastname: Khan
authors.forename: G
authors.initials: G
authors.lastname: Cockerill
authors.forename: L L
authors.initials: LL
authors.lastname: Ng
authors.forename: M
authors.initials: M
authors.lastname: Thompson
authors.forename: N J
authors.initials: NJ
authors.lastname: Samani
authors.forename: I B
authors.initials: IB
authors.lastname: Squire
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D019278:Matrix Metalloproteinase 3 / Q000097:blood*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality*; D011446:Prospective Studies; D018487:Ventricular Dysfunction, Left / Q000097:blood*; D020257:Ventricular Remodeling / Q000502:physiology*
chemical_list: C511768:MMP3 protein, human; D019278:Matrix Metalloproteinase 3