Tissue inhibitor of metalloproteinase-1 (TIMP-1) is an independent predictor of all-cause mortality, cardiac mortality, and myocardial infarction
Tissue inhibitor of metalloproteinase-1 (TIMP-1) is an independent predictor of all-cause mortality, cardiac mortality, and myocardial infarction
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DOI：
10.1016/j.ahj.2006.02.029
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发表时间：
2006-05-01
影响因子：
4.8
通讯作者：
Marmur, Jonathan D.
中科院分区：
文献类型：
--
作者：
Cavusoglu, Erdal;Ruwende, Cyril;Marmur, Jonathan D.
背景基质金属蛋白酶及其抑制剂与血管和心室重构以及动脉粥样硬化斑块破裂有关。血浆金属蛋白酶组织抑制剂-1（TIMP-1）水平在确诊或疑似冠心病患者中的预后价值尚不清楚。方法金属蛋白酶组织抑制剂-1和基质金属蛋白酶-9（MMP-9）水平，沿着其他一些已建立的生物标志物，在退伍军人管理局医疗中心进行冠状动脉造影的389例男性患者中进行测量。然后前瞻性随访患者的全因死亡率，心脏死亡率和心肌梗死（MI）的发生率。对于整个患者队列，TIMP-1是唯一独立预测全因死亡率和MI的生物标志物。此外，TIMP-1与基质金属蛋白酶-9的比值是24个月时心源性死亡率的独立预测指标。血浆TIMP-1水平在下四分位数（< 66.5 ng/mL）、四分位数间（66.5-100 ng/mL）和上四分位数（> 100 ng/mL）的患者24个月生存率分别为95.3%、89.3%和72.2%（P <0.001）。此外，当胸痛患者的风险分层为有和没有急性冠脉综合征，TIMP-1仍然是一个独立的预测因素的全因死亡率在这两个subgroup.Conclusions在一个队列的男性患者进行冠状动脉造影，血浆TIMP-1的一个单一的基线测定是独立的预测随后的死亡和MI的风险。
Background Matrix metalloproteinases and their inhibitors have been implicated in both vascular and ventricular remodeling, and in atherosclerotic plaque rupture. The prognostic value of plasma tissue inhibitor of metalloproteinase-1 (TIMP-1) levels in patients with established or suspected coronary artery disease is unknown.Methods Tissue inhibitor of metalloproteinase-1 and matrix metalloproteinase-9 (MMP-9) levels, along with a number of other established biomarkers, were measured in 389 male patients undergoing coronary angiography at a Veterans Administration Medical Center. The patients were then followed prospectively for the occurrence of all-cause mortality, cardiac mortality, and myocardial infarction (MI).Results Follow-up data at 24 months were available for 97% of the patients. For the entire cohort of patients, TIMP-1 was the only biomarker to independently predict all-cause mortality and MI. In addition, the ratio of TIMP-1 to matrix metalloproteinase-9 was independently predictive of cardiac mortality at 24 months. The 24-month survival rates for patients in the lower quartile (< 66.5 ng/mL), interquartile (66.5-100 ng/mL), and upper quartile (> 100 ng/mL) of plasma TIMP-1 values were 95.3%, 89.3%, and 72.2%, respectively (P < .001). Furthermore, when patients with chest pain were risk stratified into those with and without an acute coronary syndrome, TIMP-1 remained an independent predictor of all-cause mortality in both subgroups.Conclusions In a cohort of male patients undergoing coronary angiography, a single baseline determination of plasma TIMP-1 is independently predictive of the subsequent risk of death and MI.