title: Relation of baseline plasma MMP-1 levels to long-term all-cause mortality in patients with known or suspected coronary artery disease referred for coronary angiography.
abstract: OBJECTIVE
  To investigate the long-term prognostic significance of baseline plasma MMP-1 levels in a group of well-characterized male patients with known or suspected coronary artery disease, including those presenting with acute coronary syndrome.
  
  
  BACKGROUND
  MMP-1 is an interstitial collagenase that is considered the primary enzyme responsible for collagen degradation. In addition, MMP-1 can lead to platelet activation through the PAR1 pathway that is independent of thrombin.
  
  
  METHODS
  Baseline plasma MMP-1 levels were measured in 364 male patients who were referred for coronary angiography and followed prospectively for five years for the development of all-cause mortality.
  
  
  RESULTS
  After adjustment for a variety of baseline clinical, angiographic and laboratory parameters, baseline plasma MMP-1 levels (analyzed as a continuous variable) were an independent predictor of all-cause mortality at 5 years (HR, 1.49; 95% CI, 1.23-1.80; P < 0.0001). Furthermore, in 3 additional multivariate models that included a wide variety of contemporary biomarkers with established prognostic efficacy (i.e., ST2, GDF-15, Cystatin C, hs-CRP, Myeloperoxidase, NT-proBNP, TIMP-1, Adiponectin, RDW, hemoglobin, and Erythropoietin), MMP-1 remained an independent predictor of all-cause mortality at 5 years. Similar results were obtained when the analyses were restricted to the subpopulation of patients presenting with acute coronary syndrome.
  
  
  CONCLUSIONS
  Elevated levels of MMP-1 are associated with an increased risk of long-term all-cause mortality in patients with known or suspected coronary disease that is independent of a variety of clinical, angiographic, and laboratory variables, including a whole host of contemporary biomarkers with established prognostic efficacy representing multiple different pathophysiologic processes.
authors: Division of Cardiology, Department of Medicine, Bronx Veterans Affairs Medical Center, Bronx, NY, USA; Division of Cardiology, Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY, USA. Electronic address: ECavusoglu@aol.com.
authors: Erdal
authors: E
authors: Cavusoglu
authors: Division of Cardiology, Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY, USA.
authors: Jonathan D
authors: JD
authors: Marmur
authors: Division of Cardiology, Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY, USA.
authors: Sudhanva
authors: S
authors: Hegde
authors: Division of Cardiology, Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY, USA.
authors: Sunitha
authors: S
authors: Yanamadala
authors: Division of Hematology, Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY, USA.
authors: Olcay A
authors: OA
authors: Batuman
authors: Division of Cardiology, Department of Medicine, Bronx Veterans Affairs Medical Center, Bronx, NY, USA.
authors: Vineet
authors: V
authors: Chopra
authors: Department of Biological Sciences, University of Mersin, Mersin, Turkey.
authors: Gonca
authors: G
authors: Ay
authors: Division of Cardiology, Department of Medicine, Bronx Veterans Affairs Medical Center, Bronx, NY, USA.
authors: Calvin
authors: C
authors: Eng
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000401:mortality; D000368:Aged; D015415:Biomarkers / Q000097:blood; D003094:Collagen / Q000378:metabolism; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D020781:Matrix Metalloproteinase 1 / Q000097:blood*; D008875:Middle Aged; D015539:Platelet Activation; D011379:Prognosis; D013917:Thrombin / Q000378:metabolism
chemical_list: D015415:Biomarkers; D003094:Collagen; D013917:Thrombin; C522360:MMP1 protein, human; D020781:Matrix Metalloproteinase 1
keywords: Acute coronary syndrome; Biomarkers; Matrix metalloproteinase 1; Mortality; Prognosis
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