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

A.S. Skoromnaya


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.


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


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