Matrix metalloproteinase circulating levels, genetic polymorphisms, and susceptibility to acute myocardial infarction among patients with coronary artery disease
Matrix metalloproteinase circulating levels, genetic polymorphisms, and susceptibility to acute myocardial infarction among patients with coronary artery disease
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DOI：
10.1016/j.ahj.2007.06.042
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发表时间：
2007-12-01
影响因子：
4.8
通讯作者：
Go, Alan S.
中科院分区：
文献类型：
--
作者：
Hlatky, Mark A.;Ashley, Euan;Go, Alan S.
客观的。本研究的目的是评估急性心肌梗死（MI）患者和稳定型心绞痛患者在基质金属蛋白酶（MMP）循环水平和遗传多态性方面的系统差异。方法：我们在一个大型综合医疗保健系统中确定了冠心病的初始临床表现为急性心肌梗死或稳定的劳力性心绞痛的成年人。共909例急性心肌梗死患者、466例稳定型心绞痛患者和1023例健康老年对照者进行基因分型。从每组随机抽取199例患者，测定血清中mmp1、MMP2、MMP3、MMP9和MMP10的水平。结果在首次临床表现后15周，经常规危险因素、hs-CRP水平和心脏药物统计调整后，较高的循环MMP2和MMP9水平与急性心肌梗死独立相关。相比之下，与对照组相比，MMPI、MMP2、MMP3、MMP9或MMP10的多态性与急性心肌梗死（与心绞痛相比）或冠状动脉疾病（与对照组相比）均无显著相关性。结论：循环MMP2和MMP9水平与急性心肌梗死的发展独立相关，而不是作为冠状动脉疾病初始临床表现的稳定性心绞痛。
Objective The. aim of this study was to assess systematic differences between patients with acute myocardial infarction (MI) and patients with stable angina in matrix metalloproteinase (MMP) circulating levels and genetic polymorphisms.Methods We identified adults in a large integrated health care delivery system whose initial clinical presentation of coronary disease was either an acute MI or stable exertional angina. A total of 909 patients with acute MI, 466 patients with stable angina, and 1023 healthy older control subjects were genotyped. Serum levels of pro-MMP1, MMP2, MMP3, MMP9, and MMP10 were measured in 199 randomly selected patients from each group.Results At a median of 15 weeks after initial clinical presentation, higher circulating levels of MMP2 and MMP9 were independently associated with acute MI after statistical adjustment for conventional risk factors, hs-CRP levels, and cardiac medications. By contrast, none of the polymorphisms in MMPI, MMP2, MMP3, MMP9, or MMP10 was significantly associated with either acute MI compared with angina, or with coronary disease compared with controls.Conclusions Circulating levels of MMP2 and MMP9 are independently I associated with development of an acute MI rather than stable angina as the initial clinical presentation of coronary artery disease.