Dynamics of matrix metalloproteinase-9 in patients after STEMI for 4-year prospective observation

Researches about impact mechanisms of obesity on the AMI prognosis and course has been active in recent years, where conflicting data have been received. Objective. To investigate the matrix metalloproteinase-9 rate (MMP-9) and epicardial adipose tissue (EAT) thickness in patients with different body mass indices depending on obesity phenotype and cardiometabolic risk factors, who underwent ST-segment elevation myocardial infarction (STEMI) and percutaneous coronary intervention. Results. At the hospital admission, MMP-9 rate was increased in patients, who underwent STEMI, and its concentration was decreased only by the 48th month after index event compared to the values in healthy participants. The MMP-9 rate positively correlated with anthropometric measures of obesity: BMI, waist circumference, waist-to-hip ratio, EAT thickness. The higher the BMI, the higher the MMP-9. The MMP-9 rate in the blood wasn’t associated with mortality, acute cerebrovascular accident and repeated AMI after index event and remained comparable between groups of patients with and without terminal events. The value of EAT thickness didn’t statistically significantly differ in patients with various BMI and didn’t correlate with adverse cardiovascular events after previous STEMI and percutaneous coronary intervention. Conclusion. Controversial information about impact of obesity on acute myocardial infarction course, its outcomes and the ability to predict was obtained. Probably, there is a mechanism that conditionally divides patients with obesity and myocardial infarction into two groups. It protects the first and harms the second one. The role of MMP-9 in atherosclerosis development was proven, but insufficiently studied in myocardial infarction and obesity.