The Influence of Successful Coronary Arteries Stenting in Patients with Acute Coronary Syndrome and Ischemic Heart Disease on Proteolysis Processes Activity

A.S. Skoromnaya

Abstract


Objective: to investigate the relationship between activity of matrix metalloproteinases (MMP-2, MMP-9) and tissue inhibitor of metalloproteinases (TIMP) in coronary and systemic blood flow in patients with chronic ischemic heart disease (CIHD) and acute coronary cyndrome (ACS) after successful coronary artery (CA) stenting.
Materials and Methods. The database for the study consisted of patients with acute myocardial infarction (n = 34), who underwent primary percutaneous coronary intervention (PCI) with urgent CA stenting, and patients with CIHD (n = 32; stable angina of II–IV functional class) with planned CA stenting. Success of revascularization was assessed in all patients, study of activity of MMP-2, MMP-9 and TIMP-1 has been carried out before, immediately after and on 7th day after procedure.
Results and Discussion. It is found that levels of MMP-9 activity in CA before and after PCI were significantly higher in patients with ACS, than thereof in patients with CIHD (р ≤ 0.05). In patients with ACS was a significant sharp decline in activity of MMP-9 after successful PCI intracoronary, which gradually returned to normal by the time of discharge and in the systemic circulation. In patients with CIHD changes in MMP-9 in connection with stenting were smaller and had the character of a strong trend (p = 0.348). In patients with ACS a decrease in MMP-2 in the peripheral vein (p = 0.03), in patients with CIHD changes had the character of clear trend (p = 0.057).
Conclusions: the local and systemic degradation of the matrix with a high level of proteolytic activity is common to all patients with cardiovascular disease. Successful revascularization results in an immediate reduction in the activity of proteolysis, especially in patients with ACS, preventing further pathological remodeling of the heart and coronary vessels.


Keywords


ischemic heart disease; percutaneous coronary intervention; proteolysis; myocardium matrix metalloproteinases

References


Коваленко В.М. Регіональні особливості рівня здоров’я народу України / Коваленко В.М., Корнацький В.М. — К.: Національний науковий центр «Інститут кардіології імені акад. М.Д. Стражеска», 2011. — 165 с.

Коваленко В.М. Серцево-судинні захворювання. Рекомендації з діагностики, профілактики та лікування / Коваленко В.М., Лутай М.І. — К.: Моріон, 2011. — 408 с.

Леонов В.П. Применение статистики в статьях и диссертациях по медицине и биологии. Часть II. История биометрии и ее применения в России / Леонов В.П. // Международный журнал медицинской практики. — 2007. — № 4. — С. 19-34.

Скоромная А.С. Результаты сравнительной оценки методов определения активности матриксной металлопротеиназы 9 у больных с различными формами ишемической болезни сердца, перенесших стентирование коронарных артерий / Скоромная А.С. // Актуальні питання медичної науки та практики. — ЗМАПО, 2012. — С. 25-29.

Das U. Free radicals, cytokines and nitric oxide in cardiac failure and myocardial infarction / Das U. // Mol. Cell. Biochem. — 2000. — Vol. 215. — P. 145-152.

Falcinelli E. Platelets release active matrix metalloproteinase-2 in vivo in humans at a site of vascular injury: lack of inhibition by aspirin / Falcinelli E., Giannini S., Boschetti E., Gresele P. // Br. J. Haematol. — 2007. — Vol. 138. — P. 221-230.

Funayama H. Increases in Interleukin-6 and Matrix Metalloproteinase-9 in the Infarct-Related Coronary Artery of Acute Myocardial Infarction / Funayama H., Ishikawa S. [et al.] // Circulation. — 2004. — Vol. 68. — P. 451-454.

Galis Z. Increased expression of matrix metalloproteinases and matrix degrading activity in vulnerable regions of human atherosclerotic plaques / Galis Z., Sukhova G., Lark M., Libby P. // J. Clin. Invest. — 2004. — Vol. 94. — P. 2493-2503.

Gardner R. Renal dysfunction, as measured by the modification of diet in renal disease equations, and outcome in patients with advanced heart failure / R. Gardner [et al.] // Eur. Heart J. — 2007. — Vol. 28. — P. 3027-3033.

Higo S. Elevation of plasma matrix metalloproteinase-9 in the culprit coronary artery in patients with acute myocardial infarction: clinical evidence from distal protection / S. Higo // Circ. J. — 2005. — Vol. 69. — P. 1180-1185.

Kaartinen M. Mast cell infiltration in acute coronary syndromes: Implications for plaque rupture / Kaartinen M., Van der Wal A., Van der Loos C. [et al.] // J. Am. Coll. Cardiol. — 2008. — Vol. 32. — P. 606-612.

Kalela A. Serum matrix metalloproteinase-9 concentration in angiographically assessed coronary artery disease / Kalela A., Koiyu T., Sisto T. [et al.] // Scandinav. J. of Clin. and Lab. Investig. — 2002. — Vol. 62(5). — P. 337-342.

Kupai K. Gelatin zymography for detection of matrixmetalloproteinase-2 and -9 (MMP-2, MMP-9) from myocardium samples. A practical manual. — 2011. — P. 29.

Lalu M. Ischaemia-reperfusion injury actives matrix metalloproteinases in the human heart / Lalu M., Pasini E., Schulze C. [et al.] // Eur. Heart J. — 2005. — Vol. 26. — P. 27-35.

Libby P. Current concepts of the pathogenesis of acute coronary syndromes / Libby P. // Circulation. — 2002. — Vol. 104. — P. 365-372.

Libby P. Molecular bases of the acute coronary syndromes / Libby P. // Circulation. — 2005. — Vol. 91. — P. 2844-2850.

Lusis A. Atherosclerosis / Lusis A. // Nature. — 2000. — Vol. 407. — P. 233-241.

Maier W. ABC Stenosis Morphology Classification and Outcome of Coronary Angioplasty Reassessment with Computing Techniques / Maier W., Mini O., Antoni J. // Circulation. — 2001. — 103. — Р. 1225-1231.

Mortality statistics. acute myocardial infarction (most recent) by country: [электронный ресурс], режим доступа к ресурсу: http://www.nationmaster.com/graph/mor_acu_myo_inf-mortality-acute-myocardial-infarction.

Niccoli G. Myocardial no-reflow in humans / Niccoli G., Burzotta F., Galiuto L., Crea F. // J. Am. Coll. Cardiol. — 2009. — Vol. 54(4). — P. 281-292.

Oyama J. Reduced myocardial ischemia-reperfusion injury in toll-like receptor 4-deficient mice / Oyama J., Blais C. Jr, Liu X. [et al.] // Circulation. — 2004. — Vol. 109. — P. 784-789.

Patricia A. Zymographic techniques for the analysis of matrix metalloproteinases and their inhibitors / Snoek-van Beurden P.A., Johannes W. // BioTechniques. — 2005. — Vol. 38. — P. 27-37.

Piper H. Cellular mechanisms of ischemia-reperfusion injury / Piper H., Meuter K., Schafer C. // Ann. Thorac. Surg. — 2003. — Vol. 75. — P. 644-648.

Rodney De Palma. The prevention and management of complications during PCI / Palma R., Roguelov C., Aminian A. [et al.] // The PCR-EAPCI Textbook. Part 3. Chapter 24. — 2011.

Sawicki G. Release of gelatinase Aduring platelet aggregation / Sawicki G., Salas E., Murat J. [et al.] // Nature. — 2007. — Vol. 386. — P. 616-618.

Shah P. Human monocyte-derived macrophages induce collagen breakdown in fibrous caps of atherosclerotic plaques: Potential role of matrix-degrading metalloproteinases and implications for plaque rupture / Shah P., Falk E., Badimon J. [et al.] // Circulation. — 2005. — Vol. 92. — P. 1565-1569.

The TIMI Study Group. The Thrombolysis in Myocardial Infarction (TIMI) trial: phase I findings / The TIMI Study Group // N. Engl. J. Med. — 1984. — Vol. 33. — P. 45-52.

Virmani R. Lessons from sudden coronary death: a comprehensive morphological classification scheme for atherosclerotic lesions / Virmani R., Kolodgie F., Burke A. [et al.] // Arterioscler. Thromb. Vasc. Biol. — 2000. — Vol. 20. — P. 1262-1275.

Visse R. Matrix metalloproteinases and tissue inhibitors: structure, function, and biochemistry / Visse R., Nagase H. // Circ. Res. — 2003. — Vol. 92(8). — P. 827-39.

Wijns W. Guidelines on myocardial revascularization / Wijns W., Kolh P., Danchin N. [et al.] // The European Society of Cardiology. — 2010. — P. 40.

Wilson E. Myocardial remodelling and matrix metalloproteinases in heart failure: turmoil within the interstitium / E. Wilson, F. Spinale // Ann. Med. — 2001. — Vol. 33. — P. 623-634.

Yellon D. Myocardial reperfusion injury / Yellon D., Hausenloy D. // N. Engl. J. Med. — 2007. — Vol. 357. — P. 1121-1135.

Zijlstra F. Myocardial Blush Grade: An Angiographic Method to Assess Myocardial Reperfusion / Zijlstra F., Arnoud W., Suryapranata G. [et al.] // Eur. Heart J. — 2012. — Vol. 33. — P. 235-242.




DOI: https://doi.org/10.22141/2224-0586.2.49.2013.90599

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