INVOLVEMENT OF SERUM MATRIX METALLOPROTEINASE-9 IN PATHOGENESIS OF MYOCARDIAL INFARCTION

ABSTRACT

Cardiovascular diseases (CVD) are the leading cause of death in the World (31% of all deaths)and Mongolia as well. CVD has been the leading cause of death in Mongolia for the last 20 years and consists one of 3 death cases. In its turn 59.6% of CVD mortality caused by Ischemic heart diseases. When the coronary atherosclerotic plaque becomes vulnerable, it will a thrombus develops on that ruptured plaque and then occludes the coronary artery, which causes acute blood deficiency in the downstream myocardium. Some studies indicate that matrix metalloproteinase-9 (MMP-9) plays a key role on pathogenesis of plaque rupture.

Aim:

To study the involvement of serum MMP-9 enzyme in the pathogenesis during the rupture of the coronary atherosclerosis plaque.The study was conducted using case-control design. The main inclusion criteria of the case group is that the patient should have a ruptured coronary atherosclerotic plaque, confirmed by angiography. The total number of patients is 80, half of them belongs to the case group. MMP-9 was determined in serum by ELISA. We used CIIS (cardiac infarction injury score) by ECG and Gensini score system (Coronary Angiographic Scoring System) for assessing the severity of coronary heart disease.The average level of MMP-9 in case and control groups are 0.396±0.155 ng/ml, 0.223±0.087 ng/ ml respectively with p75%) stenosis (0.317±0.132 ng/ml), 2 vessel severe stenosis (0.348±0.157 ng/ml), 3 vessel severe stenosis (0.422±0.112 ng/ml). Furthermore, serum MMP-9 enzyme increases with accordance of severity of the myocardium injury with the statistical significance (p15, 0.376±0.132 ng/ml) group. MMP-9 levels were significantly higher in the probable injury (CIIS >15) patients compared to the possible injury (CIIS 10-15) patients (p < 0.001). An increase in serum MMP-9 enzyme levels is a risk factor of the coronary atherosclerotic plaque rupture (OR=0.001, p<0.001). MMP-9 enzyme may be a possible marker of atheromatous plaque rupture in coronary heart disease.