Department of Physiology, Universiti Kebangsaan Malaysia Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia.
Faculty of Medicine and Defense Health, National Defense University of Malaysia, 57000 Kem Sungai Besi, Malaysia.
Int J Med Sci. 2023 Feb 13;20(4):482-492. doi: 10.7150/ijms.79889. eCollection 2023.
Smoking is a risk factor of acute coronary syndrome (ACS) that could increase matrix metalloproteinases (MMPs) levels, leading to unstable coronary artery plaque. The current review aimed to identify the relationship between smoking and MMPs in patients with ACS. Literature search was conducted from inception until March 2022 in three online databases. Risk of bias was assessed using the Newcastle-Ottawa Scale. A meta-analysis was performed, and the odds ratio (OR) together with its 95% confidence interval (CI) were determined. A total of 7,843 articles were identified, and only seven studies were included. Four studies investigated the MMP-3 and MMP-9 related genes and found that smokers with certain MMPs genotypes had high risk of ACS. Smoking also increased the MMPs level in patients with ACS compared with non-smokers. Additionally, a meta-analysis of two studies resulted in an increased odd of ACS in smokers with MMP-3 5A allele versus non-smokers with MMP-3 6A6A allele (OR: 15.94, 95% CI: 10.63-23.92; =55%). In conclusion, the current review highlights the role of MMPs in relation to smoking and ACS. The determination of these roles may help in identifying new ACS markers among smokers and the development of drug-targeted treatment.
吸烟是急性冠状动脉综合征（ACS）的一个危险因素，可增加基质金属蛋白酶（MMPs）水平，导致不稳定的冠状动脉斑块。本综述旨在确定吸烟与 ACS 患者 MMPs 之间的关系。从建库开始到 2022 年 3 月，在三个在线数据库中进行了文献检索。使用纽卡斯尔-渥太华量表评估偏倚风险。进行了荟萃分析，并确定了比值比（OR）及其 95%置信区间（CI）。共确定了 7843 篇文章，仅纳入了 7 项研究。四项研究调查了 MMP-3 和 MMP-9 相关基因，发现具有某些 MMPs 基因型的吸烟者患 ACS 的风险较高。与不吸烟者相比，吸烟还会增加 ACS 患者的 MMPs 水平。此外，对两项研究的荟萃分析结果显示，与 MMP-3 5A 等位基因的不吸烟者相比，MMP-3 5A 等位基因的吸烟者发生 ACS 的几率增加（OR：15.94，95%CI：10.63-23.92； =55%）。总之，本综述强调了 MMPs 在吸烟与 ACS 之间的作用。确定这些作用可能有助于在吸烟者中确定新的 ACS 标志物，并开发针对药物靶点的治疗方法。
