Effects Of Matrix Metalloproteinases 2 Gene Polymorphisms On The Outcomes Of Patients With Acute Coronary Syndrome

Background and Objectives: Matrix metalloproteinases(MMPs)are a family of zinc-containing endoproteinases that degrade extracellular matrix components.MMP2 is one of the gelatin in the family.It plays key roles in the pathology of cardiovascular system,atherosclerotic plaque formation and plaque instability,coronary vascular restenosis,hypertension,adverse cardiovascular remodeling and progressive heart failure.Some studies found that MMP2 gene polymorphisms can influence the MMP2 plasma level by transcriptional regulation,and the latter can increase the risk of coronary heart disease and acute coronary syndrome(ACS).This study is to investigate the correlation between MMP2-1306C/T gene polymorphisms and clinical prognosis of ACS patients.Methods: We collected the data of ACS patients who admitted to the First Affiliated Hospital of Dalian University from March to November during 2013.The polymorphisms of MMP2-1306C/T gene were tested through real-time PCR method.The patients data were collected in detail: blood test,echocardiography(ventricular diameter,ventricular ejection fraction),the results of coronary angiogram.These patients were followed at least 1 years.The primary endpoint is the combinating end-point events;the secondary end-point is death,recurrent angina,recurrent myocardial infarction,heart failure,and arrhythmias.We analyzed the gene and the results of these patients' follow-up data to assess whether MMP2 gene polymorphisms influence the prognosis.Results: 1.Genotype distribution: Totally 238 recruited into the study,including 196 patients CC with genetype(82.4%),40 patients with CT genetype(16.8%),2 patients with TT genetype(0.8%).2.Comparison of coronary vascular lesions: The proportion of single,double and three coronary artery lesions tend to gradually decrease both in CC and CT/TT genetype groups.In the two groups,single lesion patients were 57.8% vs 56.2%?double 30.5% vs31.3%?three 11.7% vs 12.5% respectively,all with no statistic significance.3.Comparison of clinical prognosis: The average follow-up time was 23.2 ± 1.5months,the combined end point happened in almost half of them.The recurrence rate of angina is the most common event,44.9% in CC genetype groupe,23.8% in CT/TT groupe,followed by heart failure,and death,recurrent myocardial infarction,arrhythmias were the lowest.The frequency of recurrence of angina was higher in CC group than CT/TT group,P was 0.006,with statistic significane.The combined end point and heart failure,death,recurrent myocardial infarction and arrhythmias were not statistically significant between these two groups.4 cases happened recurrent myocardial infarction of CC genotype.Of them,3 cases was after PCI.In CT/TT groups,none of these after PCI patients happened recurrent myocardial infarction.4.Comparison of medicine taking outside the hospital: The results show that the rate of aspirin and statins was higher,both of the two groups were more than 80%.Beta blocker tacking rate in CC groupe was 72.96%,in CT/TT was 85.71%,which was higher than CC groupe.The taking of clopidogrel? ACEI/ARB was lower.But the medicine taking was not statistically significant between these two groups.5.The recurrence of angina is as the dependent variable,the independent variables are age,sex,AMI,somking,drinking,hypertension,diabetes,blood lipid levels,fasting glucose,interventional treatment,the taking of aspirin,clopidogrel,ACEI/ARB,beta blockers,statins in the hospital and out the hospital to the line 2 classification Logisitic regression analysis.The results show that there is a link between triglycerides,high-density lipoprotein cholesterol,fasting blood suger lever,AMI,MMP2-1306 CC and the recurrence of angina.Conclusions:1.In ACS patients,CC genotype were the main.The CC genotype and C allele frequency were significantly higher than CT/TT genotype and T allele frequency.This result is consistent with previous studies.2.The CC genotype increases the frequency of recurrence of angina,which indicates that the CC genotype increases the risk of the instability of the AS plaques.Myocardial infarction after PCI may also be increased in CC genetype patients.But no relevance between the CC genetype with ventricular remodeling was found.3.No significant difference was found in coronary vascular lesions counts between ACS patients with different MMP2-1306 C/T.4.MMP2-1306 CC,higher levels of triglycerides,lower leverls of high-density lipoprotein cholesterol,AMI were risk factors for the recurrence of angina.Fasting blood glucose levels was also having a relationship with the recurrence of angina.