title: Potential implications of matrix metalloproteinase-9 in assessment and treatment of coronary artery disease.
abstract: BACKGROUND
  Matrix metalloproteinase (MMP)-9, a member of the MMP superfamily is consistently implicated in the pathophysiology of atherosclerosis and plaque rupture, the most common mechanism responsible for acute coronary syndrome (ACS).
  
  
  OBJECTIVE
  To summarize the role of MMP-9 in atherosclerosis and its potential implications in assessment and treatment of coronary artery disease (CAD).
  
  
  METHODS
  We reviewed the PubMed database for relevant data regarding the role of MMP-9 in the pathophysiology of atherosclerosis. In the light of these data, we postulate potential implications of MMP-9 in the management and treatment of CAD.
  
  
  CONCLUSIONS
  Existing data strongly support the role of MMP-9 in plaque destabilization and rupture. Based on the current knowledge, MMP-9 can potentially serve as a diagnostic biomarker in ACS and a prognostic biomarker in ACS and chronic CAD patients. MMP-9 is reduced by therapies that are associated with favourable outcome in atherosclerosis and thus may serve as a surrogate biomarker of treatment efficacy. However, large morbidity and mortality trials are still required to confirm that MMP-9 reduction is associated with improved outcome independent of the traditional risk factors (i.e. low-density lipoprotein cholesterol). Given its role in plaque rupture, inhibition of MMP-9 may promote plaque stabilization and consequently reduce cardiovascular events. Yet, the efficacy and safety of MMPs inhibitors should be first studied in preclinical models of atherosclerosis.
authors.affiliation: Cardiovascular and Metabolic Diseases, Pfizer Global Research and Development, Groton, CT, USA. yuvkon@gmail.com
authors.forename: Yuval
authors.initials: Y
authors.lastname: Konstantino
authors.forename: Tu T
authors.initials: TT
authors.lastname: Nguyen
authors.forename: Robert
authors.initials: R
authors.lastname: Wolk
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Aiello
authors.forename: Steven G
authors.initials: SG
authors.lastname: Terra
authors.forename: David A
authors.initials: DA
authors.lastname: Fryburg