The prognostic value of elevated matrix metalloproteinase-9 in patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction: A two-year prospective study
Mustafa Umut Somuncu, Hamdi Pusuroglu, Seda Tukenmez Karakurt, Ali Riza Demir, Ozgur Akgul, Ozgur Surgit, Huseyin Karakurt, Ismail Bolat, Nilgun Isiksacane
article (Uluslararası, Hakemli) | Yazar(lar): Mustafa Umut Somuncu, Hamdi Pusuroglu, Seda Tukenmez Karakurt, Ali Riza Demir, Ozgur Akgul, Ozgur Surgit, Huseyin Karakurt, Ismail Bolat, Nilgun Isiksacane | Yıl: 2020 | Dergi/Kurum: REVISTA PORTUGUESA DE CARDIOLOGIA | İndeks: WOS.SCI | DOI: 10.1016/j.repc.2019.09.011 | Ana
Introduction: Increased matrix metalloproteinase-9 (MMP-9) levels in ST-elevation myocardial infarction (STEMI) are well established; however, existing data on MMP-9 values as a prognostic marker after STEMI are limited and have been conflicting.
Objective: This study aimed to assess the clinical significance of MMP-9 in predicting two- year adverse cardiovascular events in patients who underwent primary percutaneous coronary intervention (PCI) after STEMI.
Methods: In this prospective study, 204 patients with STEMI undergoing PCI were included. Participants were classified as high MMP-9 (n=102) or low MMP-9 (n=102) based on a cutoff of 12.92 ng/ml. Both groups were assessed at one and two years after STEMI.
Results: Higher cardiovascular mortality at one year was observed in the high MMP-9 group (13.7% vs. 4.9% in the low MMP-9 group, p=0.03). When the follow-up period was extended to two years, the difference in cardiovascular mortality between the groups was more significant (17.6% vs. 4.9%, p=0.004). There was no significant difference at one-year follow-up in rates of advanced heart failure, however at the end of the second year, advanced heart failure was more prevalent in the high MMP-9 group (16.7% vs. 5.9%, p=0.015). After adjustment for potential confounders, a high MMP-9 value had 3.5-fold higher odds for cardiovascular mortality at two-year follow-up than low MMP-9.
Conclusion: These results suggest that high MMP-9 levels are a strong predictor of cardiovascular mortality and advanced heart failure at two-year follow-up in STEMI patients. (c) 2020 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/bync-nd/4.0/).