Predictive utility of the changes in matrix metalloproteinase-2 in the early phase for left ventricular reverse remodeling after an acute myocardial infarction

J Am Heart Assoc. 2015 Jan 23;4(1):e001359. doi: 10.1161/JAHA.114.001359.

Abstract

Background: The relationship between the serum levels of matrix metalloproteinase (MMP) and tissue inhibitors of MMP (TIMP) and left ventricular (LV) reverse remodeling (LV-RR) after an acute myocardial infarction (AMI) has not been sufficiently examined.

Methods and results: In 25 patients with successful reperfusion after an AMI and 15 normal control subjects, the serum MMP-2 and TIMP-2 levels were measured on days 1, 2, 3, and 7 and at 1 and 6 months after the AMI onset. LV-RR was defined as a >15% decrease in the LV end-systolic volume index at 6 months after the AMI. The MMP-2 level on day 1 and TIMP-2 levels throughout the study period were comparable between the patients with and without LV-RR. The MMP-2 on day 7 (P<0.05) and the changes in the MMP-2 from day 1 to day 7 (∆MMP-2; P<0.01) were lower in patients with than in those without LV-RR. The ∆MMP-2 was strongly correlated with the changes in the LV volume and ejection fraction from 1 month to 6 months after the AMI. The ∆MMP-2 value of <-158.5 ng/mL predicted LV-RR with a high accuracy (91.7% sensitivity and 76.9% specificity; area under the curve=0.82).

Conclusions: Changes in MMP-2 are associated with LV-RR after an AMI. The ΔMMP-2 might be a useful predictor of subsequent LV-RR.

Keywords: acute myocardial infarction; metalloproteinase; remodeling.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angioplasty, Balloon, Coronary / methods*
  • Biomarkers / blood
  • Case-Control Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Logistic Models
  • Male
  • Matrix Metalloproteinase 2 / blood*
  • Middle Aged
  • Multivariate Analysis
  • Myocardial Infarction / blood*
  • Myocardial Infarction / mortality
  • Myocardial Infarction / therapy
  • Predictive Value of Tests
  • ROC Curve
  • Risk Factors
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Survival Rate
  • Tissue Inhibitor of Metalloproteinase-2 / blood*
  • Ventricular Remodeling / physiology*

Substances

  • Biomarkers
  • Tissue Inhibitor of Metalloproteinase-2
  • Matrix Metalloproteinase 2