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 Valor prognóstico da elevação das metaloproteinases de matriz 9 nos doentes submetidos a intervenção coronária percutânea primária por enfarte do miocárdio com supradesnivelamento do segmento ST: estudo prospetivo a dois anos
Revista Portuguesa de Cardiologia, cilt.39, sa.5, ss.267-276, 2020 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 39 Sayı: 5
- Basım Tarihi: 2020
- Doi Numarası: 10.1016/j.repc.2019.09.011
- Dergi Adı: Revista Portuguesa de Cardiologia
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, Directory of Open Access Journals
- Sayfa Sayıları: ss.267-276
- Anahtar Kelimeler: Extracellular matrix, Acute coronary syndrome, Cardiac mortality, Heart failure, Myocardial remodeling
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
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.