Key result
Elevated MMP-9 levels were significantly associated with an increased risk of adverse cardiovascular events in STEMI patients after PCI over a 12-month follow-up (OR 1.019).
Why the study?
The use of MMP-9 as a prognostic indicator in STEMI patients after PCI had many gaps and limited clinical experience.
Cohort (n=88)
No
Elevated MMP-9 levels measured on day 3 after STEMI are an independent predictor of adverse cardiovascular events at 1 year in patients treated with primary PCI.
Should not yet change STEMI management; hypothesis-generating for MMP-9 as a prognostic biomarker.
CĂl: PouĹžitĂ matrixovĂŠ metalopeptidĂĄzy-9 (MMP-9) u pacientĹŻ s akutnĂm infarktem myokardu s elevacemi Ăşseku ST (STEMI) po perkutĂĄnnĂ koronĂĄrnĂ intervenci (PCI) jako prognostickĂŠho indikĂĄtoru mĂĄ mnoho mezer a lĂŠkaĹskĂĄ komunita s tĂm mĂĄ velmi omezenĂŠ zkuĹĄenosti. CĂlem studie bylo zhodnotit prognostickou roli MMP-9 u pacientĹŻ se STEMI po ĂşspÄĹĄnĂŠ revaskularizaci bÄhem 12mÄsĂÄnĂho obdobĂ sledovĂĄnĂ. MateriĂĄl a metoda: Do studie bylo zaĹazeno 88 pacientĹŻ, kteĹĂ splnili kritĂŠria pro zaĹazenĂ a nemÄli ŞådnĂĄ vyluÄovacĂ kritĂŠria, jimĹž byl diagnostikovĂĄn STEMI a podstoupili primĂĄrnĂ PCI. MuŞů bylo 66 (75,0 %), s prĹŻmÄrnĂ˝m vÄkem 60,84 ± 9,68 roku. Doba sledovĂĄnĂ Äinila 12 mÄsĂcĹŻ. Byl pouĹžit sloĹženĂ˝ cĂlovĂ˝ ukazatel, kterĂ˝ zahrnoval vĂ˝skyt srdeÄnĂho selhĂĄnĂ, kterĂŠ si vyŞådalo hospitalizaci, ĂşmrtĂ z kardiovaskulĂĄrnĂch pĹĂÄin, recidivujĂcĂ infarkt myokardu, akutnĂ cerebrovaskulĂĄrnĂ pĹĂhodu. Koncentrace MMP-9 byla stanovena pomocĂ ELISA. VĂ˝sledky: Kaplanova-Meierova analĂ˝za kĹivek ukĂĄzala vĂ˝znamnou souvislost mezi zvýťenou MMP-9 a studovanĂ˝m sloĹženĂ˝m cĂlovĂ˝m ukazatelem, p = 0,0229. Pacienti s koncentracemi MMP-9 > 201,7 ng/ml mÄli signifikantnÄ vĂce cĂlovĂ˝ch ukazatelĹŻ. JednorozmÄrnĂĄ regresnĂ analĂ˝za zjistila, Ĺže MMP-9 byla indikovĂĄna jako nezĂĄvislĂĄ promÄnnĂĄ pro nepĹĂznivĂ˝ vĂ˝sledek s pomÄrem ĹĄancĂ (OR): 1,017, 95% interval spolehlivosti (CI): 1,001-1,033, p = 0,037. MultivariaÄnĂ logistickĂĄ regresnĂ analĂ˝za ukĂĄzala, Ĺže MMP-9 (OR: 1,019; 95% CI: 1,005-1,033; p = 0,009) spolu s glukĂłzou nalaÄno (OR: 1,246; 95% CI: 1,010-1,538; p = 0,040) a leukocyty (OR: 0,751; 95% CI: 0,558-1,011; p = 0,057) zĹŻstaly vĂ˝znamnĂ˝mi nezĂĄvislĂ˝mi prediktory sloĹženĂŠho cĂlovĂŠho ukazatele u studovanĂ˝ch subjektĹŻ po ĂşpravÄ dalĹĄĂch zkoumanĂ˝ch zkreslujĂcĂch faktorĹŻ, vÄku, pohlavĂ, indexu tÄlesnĂŠ hmotnosti, lipidovĂ˝ch a glukĂłzovĂ˝ch profilĹŻ. ZĂĄvÄr: U pacientĹŻ se STEMI po PCI existuje vĂ˝znamnĂ˝ vztah mezi neŞådoucĂmi ĂşÄinky a zvýťenĂ˝mi koncentracemi MMP-9. MMP-9 se bÄhem roÄnĂho sledovĂĄnĂ prokĂĄzala jako vysoce citlivĂ˝ marker pro predikci nepĹĂznivĂŠho prĹŻbÄhu onemocnÄnĂ u pacientĹŻ se STEMI.
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Kopytsya et al. (2023) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=88). Matrix metallopeptidase-9 (MMP-9) vs. Lower MMP-9 levels was evaluated on Combined endpoint (heart failure requiring hospitalization, cardiovascular death, recurrent myocardial infarction, acute cerebrovascular event) (OR 1.019, 95% CI 1.005-1.033, p=0.009). Elevated MMP-9 levels were significantly associated with an increased risk of adverse cardiovascular events in STEMI patients after PCI over a 12-month follow-up (OR 1.019).
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