Nippon Medical School, Chiba, Japan.
J Cardiol. 2012 May;59(3):374-82. doi: 10.1016/j.jjcc.2012.01.009. Epub 2012 Mar 7.
We have reported that matrix metalloproteinase-2 (MMP-2) increased in acute heart failure (AHF) and better prognosis was found in patients with greater reduction in MMP-2. We assessed whether a statin decreased MMP-2 in AHF.
The serum MMP-2 levels were measured on admission (Day 1), Day 3, Day 7, and Day 14 in 50 AHF patients. The patients were randomized to either atorvastatin (n=25) or control group (n=25). Atorvastatin (10-20mg/day) was started within 12h after their admission and then was continued for two weeks. There were no differences in the serum levels of MMP-2 on Day 1 between atorvastatin group (1400.4±318.6ng/ml) and control group (1292.7±384.7ng/ml). MMP-2 significantly decreased in both groups on Day 3, 7, and 14. However, the MMP-2 value on Day 3 compared to Day 1 was observed to have decreased significantly in atorvastatin group (561.8±235.1ng/ml) compared to control group (272.6±270.6ng/ml; p=0.001). HF events which were defined as death from HF, readmission to hospital for HF, or prolonged hospital stay because of uncontrollable HF, occurred more in control group than in atorvastatin group. Kaplan-Meier curves showed that the prognosis of HF was significantly better in atorvastatin group as compared with control group (log-rank test, p=0.037).
In addition to conventional HF therapy, an early start of atorvastatin caused a great decrease in MMP-2 and also improved HF events in AHF.
我们曾报道基质金属蛋白酶-2（MMP-2）在急性心力衰竭（AHF）中增加，并且 MMP-2 降低幅度较大的患者预后更好。我们评估了他汀类药物是否能降低 AHF 中的 MMP-2。
50 例 AHF 患者入院时（第 1 天）、第 3 天、第 7 天和第 14 天测量血清 MMP-2 水平。患者被随机分为阿托伐他汀组（n=25）或对照组（n=25）。阿托伐他汀（10-20mg/天）在入院后 12 小时内开始使用，然后持续使用两周。阿托伐他汀组（1400.4±318.6ng/ml）和对照组（1292.7±384.7ng/ml）在第 1 天的血清 MMP-2 水平无差异。两组在第 3 天、第 7 天和第 14 天 MMP-2 均显著下降。然而，与对照组（272.6±270.6ng/ml；p=0.001）相比，阿托伐他汀组第 3 天与第 1 天相比，MMP-2 值显著降低（561.8±235.1ng/ml）。HF 事件定义为 HF 死亡、因 HF 再次住院或因 HF 无法控制而延长住院时间，对照组比阿托伐他汀组更常见。Kaplan-Meier 曲线显示，与对照组相比，阿托伐他汀组 HF 的预后明显更好（对数秩检验，p=0.037）。
除了常规 HF 治疗外，早期开始阿托伐他汀治疗可显著降低 MMP-2，并改善 AHF 中的 HF 事件。
