© 2008 European Society of Cardiology
Circulating Stromelysin-1 (MMP-3): A novel predictor of LV dysfunction, remodelling and all-cause mortality after acute myocardial infarction
a Department of Cardiovascular Sciences, University of Leicester UK
b Department of Vascular Surgery, St George's Hospital Medical School London, UK
* Corresponding author. Department of Cardiovascular Sciences, Clinical Sciences Building, Leicester Royal Infirmary, Leicester LE2 7LX, UK. Tel.: +44 116 252 3125; fax: +44 252 3108. E-mail address: is11{at}le.ac.uk (I.B. Squire).
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Abstract |
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Introduction: Changes to cardiac matrix are central to ventricular remodelling after acute MI and matrix metalloproteinase expression is implicated in this process. We investigated the temporal profile of MMP-3 and its relationship to LV dysfunction and prognosis following AMI.
Methods: We studied 382 patients with AMI. Plasma MMP-3 was measured at 0–12, 12–24 h and for subsequent 24 h periods during admission. LV function (LVEF) was assessed by echocardiography pre-discharge and at a median of 148 days and clinical endpoints at a median of 313 days.
Results: MMP-3 peaked prior to discharge thus pre-discharge levels were used in analyses. MMP-3 was associated with patient age (p<0.001), creatinine (p<0.001) and was higher in males (p<0.001) and hypertensives (p<0.001). MMP-3 inversely correlated with LVEF at follow-up (p=0.043), was higher in subjects with LVEF <40% (p=0.017) and in subjects with increasing EDV (p=0.017) or ESV (p=0.007) compared to those in whom volumes fell between visits. In the 58 patients reaching the endpoint of death or heart failure, MMP-3 was higher (p<0.001). On Kaplan–Meier analysis, subjects with levels above optimum cut off identified via ROC curves were more likely to suffer a clinical event (p=0.037).
Conclusion: MMP-3 is associated with left ventricular dysfunction, adverse left ventricular remodelling and prognosis after AMI.
Key Words: Matrix metalloproteinase • Heart failure • Acute myocardial infarction
Received July 11, 2007; Revised October 20, 2007; Accepted December 5, 2007
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