Majalah Kardiologi Indonesia (Mar 2014)

Differences of Serum Ratio MMP-9/TIMP-1 in ST-Elevation Myocardial Infarction (STEMI) and Non ST-Elevation Acute Coronary Syndrome (NSTEACS)

  • Basuki Rahmat,
  • Lucia Kris Dinarti,
  • Irmalita I,
  • Budi Yuli Setianto

DOI
https://doi.org/10.30701/ijc.v34i3.337
Journal volume & issue
Vol. 34, no. 3

Abstract

Read online

Background: Differences between the pathogenesis of ST-Elevation Myocardial infarction (STEMI) and Non-ST Elevation Acute Coronary Syndrome (NSTE-ACS) had yet unknown. Matrix metalloproteinase-9 (MMP-9) as the matrix degradation enzyme secreted by inflammatory cells play a role in the pathogenesis of plaque rupture. MMP-9 proteolytic activity is inhibited by specific inhibitors of the Tissue Inhibitor of metalloproteinase-1 (TIMP-1). MMP-9/TIMP-1 ratio describes the actual proteolytic activity of MMP-9. This ratio may distinguish the pathogenesis of STEMI and NSTE-ACS. Objective: To examine the difference serum level ratio MMP-9/TIMP-1 in patients with STEMI and NSTE-ACS. Methods and subjects: This is a cross-sectional study which recruits patients consecutively with ACS admitted to ICCU of Dr. Sardjito General Hospital Yogyakarta within 24 h onset. Acute infection, chronic inflammation, acute stroke, kidney failure requiring renal replacement therapy, chronic heart failure, liver cirrhosis, acute exacerbation of COPD and pneumonia, thromboembolic disease, malignancy, pregnancy and the use of steroids and steroid anti-inflammatory drugs are excluded. Serum levels of MMP-9 and TIMP-1 examined using the method of sandwich enzyme-linked immunosorbent assay (ELISA). Results: The total of 60 subjects with STEMI patients 31 (51.7%) and NSTEACS 29 (48.3%). Level of serum MMP-9/TIMP-1 ratio is significantly higher in STEMI compared to NSTE-ACS (1.106 0.065 vs. 1.046 0.057, p 1.0639 has a prevalence risk of 1.7 times having STEMI (p = 0.039; KI95% from 1.040 to 8.508). Levels of serum MMP-9/TIMP-1 ratio significantly higher in STEMI compared to NSTEMI group (p = 0.003) and in the STEMI and UAP group (0.026), but did not differ significantly in NSTEMI and UAP group (p = 0.045). Conclusion: High levels of serum MMP-9/TIMP-1 ratio in patients with STEMI than NSTEACS may explain the role of serum MMP-9/TIMP-1 ratio in differentiating the pathogenesis of STEMI and NSTE-ACS. (J Kardiol Indones. 2013;34:160-6)

Keywords