Evaluating the relationship of matrix metalloproteinase-1 (MMP-1), tissue inhibitor (TIMP-1) and oxidized LDL with coronary angiography results in patients with acute coronary syndrome

The formation of atherosclerotic plague with some inflammatory processes plays a role in the development of acute coronary syndrome which occurs with variable clinical diseases changing from unstable angina pectoris to acute myocardial infarction. It has been suggested that different subgroups of matrix metalloproteinases, tissue inhibitors and oxidized LDL were included in these inflammatory processes and seperate pathways of developing ischaemia-reperfusion injury. Today, the relation between MMP-1 and OxLDL which are proposed to constitute early mortal injuries in the first minutes of coronary reperfusion and their changes in myocardial injury process is not clarified yet.In our study to determine the value of MMP-1, TIMP-1 and OxLDL in diagnosis and prognosis of patients with ACS, the assays in blood samples that have been collected from 39 patients with the diagnosis of stable angina, unstable angina, acute myocardial infarction and 17 people forming the control group who had no cardiovascular diseases were studied with ELISA. First blood samples were collected 6.-12. hours after registration and second samples were collected 18.-36. hours after the first samples. All samples were taken before coronary angiography. MMP-1, TIMP-1 and OxLDL were compared to coronary angiography results and the other cardiac markers. A moderate correlation was found between the ratio of the simultan blood levels of MMP-1, TIMP-1 and Gensini score which predict the severity of vessel lesions ( r =0.501, p<0.048 ). A correlation was found between the first sample levels of MMP-1 and second sample levels of TIMP-1 ( r = 0.811, p<0.001 ).Our study suggested that the ratio of MMP-1 and TIMP-1 levels in patients with ACS might have a prognostic value to determine the vascular lesion severity with elimination of the effect of cardiac catheterization. For their use as a non-invasive prognostic marker, well controlled and defined studies in larger study groups should be considered.Key words: ACS, MMP-1, TIMP-1, OxLDL, Modified Gensini Score