Expressions and clinical significance of factors related to acute coronary syndrome.

Acute coronary syndrome (ACS) is the acute stage of coronary artery disease, which remains a major cause of mortality and morbidity. It is essential to explore the role of matrix metalloproteinase -2 (MMP-2) and interleukin (IL)-18 and their association with disease in patients with severe ACS. Circulating MMP-2 and IL-18 levels were measured using enzyme linked immunosorbent assay (ELISA) in 94 subjects with acute coronary syndrome (ACS, n=38), stable angina pectoris (SAP, n=27) and healthy individuals (control group, n=29). We examined the correlations between the levels of MMP-2 and IL-18 and cardiac risk factors in ACS. Logistic regression analysis was performed to screen for factors that predict ACS. Both MMP-2 and IL-18 concentrations were increased in the ACS group compared to the SAP group or control group (P less than 0.01). Especially, MMP-2 and IL-18 were highly expressed in the patients with ST elevated myocardial infarction (STEMI). Both serum levels of MMP-2 and IL-18 in the single-, double- and triple-vessel lesion group were higher compared to the control group (P less than 0.01). MMP-2 levels were positively correlated with IL-18 (r=0.639, P less than 0.01), CK-MB (r=0.47, P=0.003) and hs-CRP levels (r=0.583, P less than 0.01). The logistic regression analysis showed that increases in MMP-2 levels may be a powerful predictor of ACS. Thus, the changes in levels of serum MMP-2 and IL-18 may be useful in the diagnosis of ACS and prediction of its prognosis.