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• W2321807391 abstract "Purpose: Reperfusion injury is central to the pathophysiology of microvascular obstruction (MVO) after primary percutaneous coronary intervention (p-PCI). Matrix metalloproteinases (MMPs) do not only regulate the release of proinflammatory cytokines and the expression of adhesion molecules but also facilitate leukocyte transmigration across the endothelium during an inflammatory response. The aim of this study was to investigate the relation of periprocedural plasma MMP- 8 and -9 levels to MVO after p-PCI in patients with acute ST segment elevation myocardial infarction (STEMI).Methods: Forty-two patients with acute STEMI who underwent p-PCI within 12 hours of the onset of symptoms were prospectively enrolled. Plasma samples for MMP-8 and-9 analysis were obtained on admission and at post-PCI 6th and 24th hours. MVO was assessed and quantified by the index of microcirculatory resistance (IMR) measured with the use of a guidewire tipped with pressure and temperature sensors on post-PCI day 4 to 5.Results: When we categorized the patients according to the mean value of IMR (30 U) and define MVO as IMR>30 U, baseline MMP 8 (21.1±18.6 vs 8.1±4.3, p=0.001) and baseline MMP 9 (108.8±76.4 vs 71.9±59.4, p=0.013) levels were significantly higher in patients with MVO. However, there was no difference between the two groups with respect to the MMP levels at the 6th and 24th hours (Figure 1). Plasma MMP-8 and -9 levels on admission were positively correlated with IMR (r=0.56 p<0.001 and r=0.47 p=0.002, respectively). However, magnitude of change (in percentages) in plasma MMP-8 and -9 levels between admission and post-PCI 6th hour was negatively correlated with IMR (r=-0.38 p=0.01 and r=-0.34 p=0.03, respectively). In addition to MMP-8 and -9, D-dimer (r = 0.38, p=0.016) and BNP (r =0.46, p=0.003) levels on admission, peak troponin level (r =0.27, p=0.077) and age (r =0.28, p=0.07) were also found to be significantly correlated with IMR. Multiple linear regression analysis revealed that MMP-8 level on admission (β=0.526, p=0.025) and BNP level on admission (β=0.056, p=0.038) were independently associated with IMR.Conclusions: Plasma MMP-8 level on admission is related to microvascular obstruction after p-PCI and significantly correlated with IMR. Furthermore, the presence of MVO seems to influence the dynamic nature of the MMPs after p-PCI. MMP inhibitors may be targets for future studies investigating alternative strategies for prevention of MVO." @default.
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• W2321807391 date "2013-08-02" @default.
• W2321807391 modified "2023-10-02" @default.
• W2321807391 title "Relation of periprocedural plasma matrix metalloproteinase-8 and -9 levels to microvascular obstruction after primary percutaneous coronary intervention" @default.
• W2321807391 doi "https://doi.org/10.1093/eurheartj/eht310.p5510" @default.
• W2321807391 hasPublicationYear "2013" @default.
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