title: A sirtuin 1/MMP2 prognostic index for myocardial infarction in patients with advanced coronary artery disease.
abstract: BACKGROUND
  Sirtuin 1 (SIRT1) appears to play a protective role against endothelial dysfunction and oxidative stress. Instead, matrix metalloproteinase 2 (MMP2) is involved in acute coronary events, by promoting tissue remodeling. This study sought to determine the clinical value of a prognostic index arising from the combination of these two biomarkers for myocardial infarction (MI) in patients with advanced coronary artery disease.
  
  
  METHODS
  Eighty-one patients with advanced coronary artery disease planned for open heart surgery were prospectively enrolled. Serum levels of SIRT1 and MMP2 were measured by ELISA. To look at the relation of these mediators with clinical characteristics, pre-operative data and patients demographics were collected.
  
  
  RESULTS
  SIRT1 levels correlated marginally with a history of hypertension (ρ=0.2, p=0.084) and inversely with baseline urea (ρ=0.25, p=0.056). When performing additional adjustment, low SIRT1 levels were independently associated with diabetes mellitus 2(DM2) and subjects with SIRT1 <2.95ng/mL were more prone to present DM2 (82% sensitivity and 62% specificity). The index of low SIRT1 and high MMP2 respectively correlated with patients history of MI (ρ=0.3, p=0.01) and marginally with presence or history of atrial fibrillation (AF) (ρ=0.213, p=0.076). When adjusting for anthropometric and comorbidities, the combined index tended to have an association with impaired ejection fraction (EF)<55% (p=0.059).
  
  
  CONCLUSIONS
  The combined index of low SIRT1 and high MMP2 exhibited a significant correlation with history of MI and EF, promoting a potential prognostic tool for MI incidence in patients regardless their coronary artery disease status.
authors.affiliation: Laboratory for Experimental Surgery and Surgical Research "N.S Christeas", Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece.
authors.forename: Ilias P
authors.initials: IP
authors.lastname: Doulamis
authors.affiliation: Laboratory for Experimental Surgery and Surgical Research "N.S Christeas", Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece. Electronic address: asptzani@gmail.com.
authors.forename: Aspasia I
authors.initials: AI
authors.lastname: Tzani
authors.affiliation: Laboratory for Experimental Surgery and Surgical Research "N.S Christeas", Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece.
authors.forename: Panagiotis S
authors.initials: PS
authors.lastname: Konstantopoulos
authors.affiliation: First Department of Adult Cardiac Surgery, Onassis Cardiac Surgery Center, Athens 17674, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Samanidis
authors.affiliation: 1st Department of Cardiology, 'Hippokration' Hospital, University of Athens Medical School, Athens, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Georgiopoulos
authors.affiliation: 1st Department of Cardiology, 'Hippokration' Hospital, University of Athens Medical School, Athens, Greece.
authors.forename: Konstantinos P
authors.initials: KP
authors.lastname: Toutouzas
authors.affiliation: Laboratory for Experimental Surgery and Surgical Research "N.S Christeas", Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece.
authors.forename: Despina N
authors.initials: DN
authors.lastname: Perrea
authors.affiliation: First Department of Adult Cardiac Surgery, Onassis Cardiac Surgery Center, Athens 17674, Greece.
authors.forename: Konstantinos G
authors.initials: KG
authors.lastname: Perreas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D020778:Matrix Metalloproteinase 2 / Q000097:blood*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis / Q000209:etiology*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D056564:Sirtuin 1 / Q000097:blood*
chemical_list: D015415:Biomarkers; D020778:Matrix Metalloproteinase 2; D056564:Sirtuin 1
keywords: Cardiac remodeling; Coronary artery disease; Endothelial dysfunction; Myocardial infarction; Prognostic index