Setianto Budi Y, Mubarika Sofia, Irawan Bambang, Astuti Indwiani
Department of Cardiology and Vascular Medicine, Faculty of Medicine Gadjah Mada University - Dr. Sardjito Hospital, Yogyakarta, Indonesia.
Department of Histology and Molecular Biology, Faculty of Medicine Gadjah Mada University, Yogyakarta, Indonesia.
Cardiol Res. 2012 Oct;3(5):222-229. doi: 10.4021/cr210w. Epub 2012 Sep 20.
Matrix metalloproteinase (MMP)-9 is excessively expressed in frail region of atherosclerotic plaque and released in circulation following plaque rupture. High MMP-9 level associated with severity of occluded thrombus and subsequent myocardial infarction. MMP-9 (-1562C>T) polymorphism associated with acute myocardial infarction, however conflicting data present regarding impact of MMP-9 (-1562C>T) polymorphism on circulating MMP-9 level in acute myocardial infarction with ST-elevation (STEMI), clinical entity represents totally occluded coronary thrombus.
We enrolled consecutively subjects with acute coronary syndrome treated in intensive coronary care unit. Acute coronary syndrome diagnosis were classified into STEMI and non-ST-elevation acute coronary syndrome (NSTEACS). Seventy consecutive subjects were enrolled for this study, 31 subjects with STEMI and 39 subjects with NSTEACS.
On admission serum MMP-9 level, measured with sandwich enzyme immunoassay, were higher in STEMI as compared with NSTEACS (1,574.2 ± 604.1 ng/mL vs. 1,104.4 ± 591.5 ng/mL, P < 0.01). Proportion of subjects with MMP-9 (-1562C>T) polymorphism, analyzed with PCR-RFLP, were higher in STEMI as compared with NSTEACS (66.7% vs. 33.3%, P = 0.15). T allele frequency was almost twice in STEMI as compared to in NSTEACS. Almost all (83%) subjects with MMP-9 (-1562C>T) polymorphism had high serum MMP-9 level (> 1,334.5 ng/mL) during STEMI, whereas in NSTEACS all subjects had low level.
MMP-9 (-1562C>T) polymorphism associated with high serum MMP-9 level in patients with STEMI.
基质金属蛋白酶（MMP）-9在动脉粥样硬化斑块的脆弱区域过度表达，并在斑块破裂后释放到循环中。高MMP-9水平与闭塞性血栓的严重程度及随后的心肌梗死相关。MMP-9（-1562C>T）多态性与急性心肌梗死相关，然而，关于MMP-9（-1562C>T）多态性对ST段抬高型急性心肌梗死（STEMI，代表完全闭塞的冠状动脉血栓的临床实体）患者循环MMP-9水平的影响，存在相互矛盾的数据。
我们连续纳入在冠心病重症监护病房接受治疗的急性冠状动脉综合征患者。急性冠状动脉综合征诊断分为STEMI和非ST段抬高型急性冠状动脉综合征（NSTEACS）。本研究连续纳入70例患者，其中31例STEMI患者和39例NSTEACS患者。
入院时，采用夹心酶免疫测定法测得的血清MMP-9水平，STEMI患者高于NSTEACS患者（1574.2±604.1 ng/mL对1104.4±591.5 ng/mL，P<0.01）。采用聚合酶链反应-限制性片段长度多态性（PCR-RFLP）分析，MMP-9（-1562C>T）多态性患者的比例，STEMI患者高于NSTEACS患者（66.7%对33.3%，P = 0.15）。STEMI患者的T等位基因频率几乎是非ST段抬高型急性冠状动脉综合征患者的两倍。几乎所有（83%）具有MMP-9（-1562C>T）多态性的STEMI患者血清MMP-9水平较高（>1334.5 ng/mL），而在NSTEACS患者中所有患者水平较低。
MMP-9（-1562C>T）多态性与STEMI患者血清MMP-9高水平相关。
