on May 11, 2006
Published online before print May 11, 2006, doi: 10.1161/01.ATV.0000226544.93089.7f
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Submitted on December 20, 2005
Accepted on April 26, 2006
Elevated Plasma Active Matrix Metalloproteinase-9 Level Is Associated With Coronary Artery In-Stent Restenosis
Gregory T. Jones *;
From the Sections of Surgery (G.T.J., L.V.P., A.M.v.) and Medicine (I.P.K., J.W.S.C., G.T.W., M.M., M.J.A.W.), University of Otago, Dunedin, New Zealand.
* To whom correspondence should be addressed. E-mail: greg.jones{at}otago.ac.nz.
Objective--This study aimed to determine whether the plasma levels of matrix metalloproteinase-9 (MMP-9) or tissue inhibitor of metalloproteinases-1 (TIMP-1) were altered in patients with a history of symptomatic in-stent restenosis (ISR).
Methods and Results--A group of 158 patients with a history of ISR were compared with 128 symptom-free patients. Plasma samples and a detailed risk factor history were collected. Plasma samples were analyzed for pro-MMP-9 and latent MMP-9 and active MMP-9, latent MMP-3, and TIMP-1. Several variables were associated with ISR, including index coronary disease extent and severity (number of diseased vessels and American College of Cardiology/American Heart Association lesion classification), number, diameter, and total length of stent(s) inserted, and plasma high-density lipoprotein cholesterol. Plasma active MMP-9 (odds ratio, 1.96; 95% CI, 1.43 to 2.69) showed independent risk association with ISR. Patients with multiple sites of ISR had significantly higher levels of active MMP-9 compared with patients with only a single ISR lesion or no ISR.
Conclusion--Plasma active MMP-9 levels may be a useful independent predictor of bare metal stent ISR.
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