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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2006;26:1538.)
© 2006 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Elevated Plasma Active Matrix Metalloproteinase-9 Level Is Associated With Coronary Artery In-Stent Restenosis

Gregory T. Jones; I. Patrick Kay; J.W.S. Chu; G.T. Wilkins; L.V. Phillips; M. McCormick; A.M. van Rij; M.J.A. Williams
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.

Key Words: plasma • MMP-9 • TIMP-1 • restenosis