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Kobayashi, Nobuaki; Takano, Masamichi; Hata, Noritake; Kume, Noriaki; Tsurumi, Masafumi; Shirakabe, Akihiro; Okazaki, Hirotake; Shibuya, Junsuke; Shiomura, Reiko; Nishigoori, Suguru; Seino, Yoshihiko; Shimizu, Wataru

Matrix Metalloproteinase-9 as a Marker for Plaque Rupture and a Predictor of Adverse Clinical Outcome in Patients with Acute Coronary Syndrome: An Optical Coherence Tomography Study

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  • Media type: E-Article
  • Title: Matrix Metalloproteinase-9 as a Marker for Plaque Rupture and a Predictor of Adverse Clinical Outcome in Patients with Acute Coronary Syndrome: An Optical Coherence Tomography Study
  • Contributor: Kobayashi, Nobuaki; Takano, Masamichi; Hata, Noritake; Kume, Noriaki; Tsurumi, Masafumi; Shirakabe, Akihiro; Okazaki, Hirotake; Shibuya, Junsuke; Shiomura, Reiko; Nishigoori, Suguru; Seino, Yoshihiko; Shimizu, Wataru
  • imprint: S. Karger AG, 2016
  • Published in: Cardiology
  • Language: English
  • DOI: 10.1159/000445994
  • ISSN: 0008-6312; 1421-9751
  • Keywords: Pharmacology (medical) ; Cardiology and Cardiovascular Medicine
  • Origination:
  • Footnote:
  • Description: <jats:p>&lt;b&gt;&lt;i&gt;Objectives:&lt;/i&gt;&lt;/b&gt; The present study sought to clarify the relationship between matrix metalloproteinase-9 (MMP-9) levels and plaque morphology demonstrated by optical coherence tomography (OCT), and to examine their prognostic impacts in patients with acute coronary syndrome (ACS). &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; MMP-9 levels were measured for patients with ACS (n = 249). Among 249 patients, 120 with evaluable OCT images were categorized into patients with ruptured plaques (n = 65) and those with nonruptured plaques (n = 55) on the basis of culprit lesion plaque morphology demonstrated by OCT. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; MMP-9 levels on admission were significantly higher in the rupture group than in the nonrupture group (p = 0.029). Although creatine kinase-MB (CK-MB) on admission was comparable between the groups, peak CK-MB was higher in the rupture group than in the nonrupture group (p &lt; 0.001). By receiver operating characteristic curve analysis, the optimal cut-off value of MMP-9 to detect ruptured plaques was 65.5 ng/ml (p = 0.029). There was a nonstatistically significant trend toward increased cardiac death at 2 years (5.9 vs. 1.0%, p = 0.059) in patients with high MMP-9 (≥65.5 ng/ml) compared to those with low MMP-9 (&lt;65.5 ng/ml). &lt;b&gt;&lt;i&gt;Conclusions:&lt;/i&gt;&lt;/b&gt; MMP-9 can differentiate ACS with ruptured plaques from nonruptured plaques, and MMP-9 may be a valuable predictor of long-term cardiac mortality in patients with ACS reflecting plaque rupture.</jats:p>