| Objective: Matrix metalloproteinase-9(MMP-9)promote weakening of the fibrouscap and trigger plaque cell apoptosis by degrading extracellular matrix(ECM),leading toplaque erosion and rupture,which leads to the occurrence of acute coronary sdyndrome(ACS).Macrophage migration inhibitory factor(MIF)can promote MMP-9expression andplays a pivotal role in the development of ACS.To evaluate the early diagnostic value ofMMP-9levels and MIF levels on admission and observe the time dependent changes ofMMP-9and MIF trend for ST-segment elevation myocardial infarction(STEMI),explorethe relationship among MMP-9,MIF and global registry of acute coronary events(GRACE)scores and determine the predict values of MMP-9and MIF in short-termprognosis of STEMI about major adverse cardiovascular events(MACE).Methods:A totalof55STEMI patients admitted into our hospital between September2011and February2012were recruited.The sampling as points1,2,3,4,5and6were no more than4h,8h,12h,24h,48h and more than72h after onset then arrival at the emergency room.The controlgroups were fifty subjects of coronary artery without significant stenosis after angiographyand healthy volunteers respectively.The plasma levels of MMP-9and MIF in venousblood were detected with enzyme-linked immunosorbent assay (ELISA).The GRACE riskscore was used for risk assessment.The incidence of new or recurrent myocardialinfarction,target vessel revascularization,cardiac death,heart failure(MACE) was recordedduring a follow-up period of6months.Results:1.Serum levels of MMP-9and MIF in eachgroup:The MMP-9levels were in patients at point1(1.53±0.90μg/ml,P<0.001),point2 (1.49±0.88μg/ml,P<0.001),point3(1.65±0.79μg/ml,P<0.001), point4(1.89±0.72μg/ml,P<0.001),point5(1.81±0.71μg/ml,P<0.001),point6(1.89±0.72μg/ml,P<0.001) comparedto the control groups.The MIF levels were in patients at point1(2.99±2.40ng/ml,P<0.01),point2(2.89±2.42ng/ml,P<0.01),point3(2.45±2.15ng/ml,P>0.05),point4(2.37±1.97ng/ml,P>0.05),point5(2.26±2.35ng/ml,P>0.05),point6(1.75±1.17ng/ml, P>0.05) comparedto the control groups,There was no statistical differences ex-isted between coronary arterywithout significant stenosis after angiography group (1.70ng/ml) and healthy volunteersgroup(1.71ng/ml,P>0.05).2.The MMP-9levels were higher in patients at point6(P<0.05),point4(P<0.05)than point1and at poi-nt4(P<0.05),at points5(P<0.05),at points6(P<0.05)was higher than points2.The MIF levels were lower in patients at points6thanpoints1(P<0.05),points2(P<0.05).On receiver operating characteristic curve analysis,area under the curve of points1,2,3,4and5was0.725,0.652,0.555,0.581and0.493forMIF,and0.987,0.949,0.995,0.989and0.977for MMP-9,and0.852,0.967,0.976,0.955and0.870for CK-MB, respectively.3.MMP-9and MIF serum levels among differentcoronary artery lesion degree in patients with ACS:Neither MMP-9nor MIF wasstatistical difference between above the50percentile group and under the50percentilegroup in patie-nts with STEMI (P>0.05).4.MACE occurred in8[14.5%(8/55)] patientsduring ho-spitalization and17[30.9%(17/55)] patients during follow-up.Receiveroperating characteristic (ROC) curve analysis showed area under the curve (AUC) ofMMP-9levels,MIF levels and admission GRACE risk score and were0.750,0.739and0.848respectively.ROC curve analysis showed AUC of MMP-9levels,MIF levels andhospital discharge GRACE risk score were0.711,0.690and0.737respectively.Nostatistical differences existed among MMP-9levels,MIF levels and GRACE risk score forpredicting the short-term risk of MACE (P>0.05).Conclusion:1.The plasma levels ofMMP-9and MIF were significantly higher in patients with STEMI within4hours of theonset of symptoms and have a higher diagnostic value for early STEMI.2.The peak ofMMP-9levels was12-24hours after onset and the peak for at least72hours,The peak ofMIF levels was in four hours after onset and the peak lasted more than24hours,decreased to normal levels within72hours.3.MMP-9, MIF has higher predictivevalue of short-term risk of MACE in patients of STEMI. |
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