title: Peripheral blood levels of matrix and inflammatory mediators are elevated in Tunisian patients with acute coronary syndromes.
abstract: BACKGROUND
  The aim of the present study was to investigate differences of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 in the peripheral blood of patients admitted with acute coronary syndrome (ACS), in correlation with the widely accepted markers of inflammatory activity, C-reactive protein, fibrinogen, and white blood cell number.
  
  
  METHODS
  315 patients with ACS (165 unstable angina pectoris/non-ST-elevation myocardial infarction, 150 ST-elevation myocardial infarction), 111 stable angina (SA) patients, and 296 control subjects were enrolled in the study. All biochemical analyses were carried out using a Hitachi 912 analyzer (Roche). Matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) levels were determined in citrate plasma by ELISA methods. White blood cells (WBC) and fibrinogen were also determined.
  
  
  RESULTS
  The plasma concentrations of matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-1, C-reactive protein, fibrinogen, and white blood cells in patients with acute coronary syndrome were significantly elevated compared to the control group (p < 0.001). MMP-9/TIMP-1 ratio was significantly higher in SA and ACS patients (p < 0.001) than controls. Strong positive associations were observed between MMP-9 and TIMP-1 (r = 0.213, p < 0.01), MMP-9 and CRP (r = 0.103, p < 0.01), MMP-9 and fibrinogen (r = 0.299, p < 0.01), MMP-9 and WBC (r = 0.135, p < 0.01), TIMP-1 and CRP (r = 0.219, p < 0.01), TIMP-1 and Fibrinogen (r = 0.226, p < 0.01), TIMP-1 and WBC (r = 0.094, p < 0.1), CRP and fibrinogen (r = 0.158, p < 0.01), CRP and WBC (r = 0.156, p < 0.01, and finally between fibrinogen and WBC (r = 0.234, p < 0.01) in the patients with ACS.
  
  
  CONCLUSIONS
  In conclusion, our observations suggest that ACS shows an increase in both remodeling and inflammation markers. In addition, the strong relationship with MMP-9 and inflammatory mediators such as CRP, fibrinogen, and WBC in ACS patients suggests that MMP-9 might be an additional marker and/or consequence of inflammatory components in ACS.
authors.affiliation: L99ES11 Research Laboratory and Department of Biochemistry, Rabta University Hospital Tunis, Tunisia.
authors.forename: Yosra
authors.initials: Y
authors.lastname: Zayani
authors.forename: Monia
authors.initials: M
authors.lastname: Allal-Elasmi
authors.forename: Marie Paule
authors.initials: MP
authors.lastname: Jacob
authors.forename: Wiem
authors.initials: W
authors.lastname: Zidi
authors.forename: Amira
authors.initials: A
authors.lastname: Zaroui
authors.forename: Moncef
authors.initials: M
authors.lastname: Feki
authors.forename: Sami
authors.initials: S
authors.lastname: Mourali
authors.forename: Rachid
authors.initials: R
authors.lastname: Mechmech
authors.forename: Naziha
authors.initials: N
authors.lastname: Kaabachi
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000201:enzymology; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood*; D008875:Middle Aged; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000097:blood*; D014416:Tunisia
chemical_list: D018836:Inflammation Mediators; D019715:Tissue Inhibitor of Metalloproteinase-1; D005340:Fibrinogen; D002097:C-Reactive Protein; D020780:Matrix Metalloproteinase 9