title: Influence of spironolactone on matrix metalloproteinase-2 in acute decompensated heart failure.
abstract: BACKGROUND
  Matrix metalloproteinases (MMPs) are a family of enzymes important for the resorption of extracellular matrices, control of vascular remodeling and repair. Increased activity of MMP2 has been demonstrated in heart failure, and in acutely decompensated heart failure (ADHF) a decrease in circulating MMPs has been demonstrated along with successful treatment.
  
  
  OBJECTIVE
  Our aim was to test the influence of spironolactone in MMP2 levels.
  
  
  METHODS
  Secondary analysis of a prospective, interventional study including 100 patients with ADHF. Fifty patients were non-randomly assigned to spironolactone (100 mg/day) plus standard ADHF therapy (spironolactone group) or standard ADHF therapy alone (control group).
  
  
  RESULTS
  Spironolactone group patients were younger and had lower creatinine and urea levels (all p < 0.05). Baseline MMP2, NT-pro BNP and weight did not differ between spironolactone and control groups. A trend towards a more pronounced decrease in MMP2 from baseline to day 3 was observed in the spironolactone group (-21 [-50 to 19] vs 1.5 [-26 to 38] ng/mL, p = 0.06). NT-pro BNP and weight also had a greater decrease in the spironolactone group. The proportion of patients with a decrease in MMP2 levels from baseline to day 3 was also likely to be greater in the spironolactone group (50% vs 66.7%), but without statistical significance. Correlations between MMP2, NT-pro BNP and weight variation were not statistically significant.
  
  
  CONCLUSIONS
  MMP2 levels are increased in ADHF. Patients treated with spironolactone may have a greater reduction in MMP2 levels.
authors.affiliation: Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: João Pedro
authors.initials: JP
authors.lastname: Ferreira
authors.affiliation: Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: Mário
authors.initials: M
authors.lastname: Santos
authors.affiliation: Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Oliveira
authors.affiliation: Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: Irene
authors.initials: I
authors.lastname: Marques
authors.affiliation: Centro Hospitalar São João, Porto, Portugal.
authors.forename: Paulo
authors.initials: P
authors.lastname: Bettencourt
authors.affiliation: Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: Henrique
authors.initials: H
authors.lastname: Carvalho
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight / Q000187:drug effects; D003404:Creatinine / Q000097:blood; D004232:Diuretics / Q000627:therapeutic use*; D005260:Female; D006333:Heart Failure / Q000378:metabolism*; D006801:Humans; D008297:Male; D020778:Matrix Metalloproteinase 2 / Q000378:metabolism*; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000378:metabolism; D010446:Peptide Fragments / Q000378:metabolism; D011446:Prospective Studies; D013148:Spironolactone / Q000627:therapeutic use*; D014508:Urea / Q000097:blood
chemical_list: D004232:Diuretics; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D013148:Spironolactone; D014508:Urea; D003404:Creatinine; D020778:Matrix Metalloproteinase 2