Association between circulating matrix metalloproteinase levels and coronary plaque regression after acute coronary syndrome--subanalysis of the JAPAN-ACS study

Atherosclerosis. 2013 Jan;226(1):275-80. doi: 10.1016/j.atherosclerosis.2012.10.063. Epub 2012 Nov 2.

Abstract

Background: Matrix metalloproteinases (MMPs) have been implicated in development of atherosclerosis. MMPs are activated in patients with acute coronary syndrome (ACS). However, little data exist regarding the correlation between circulating levels of MMPs and plaque volume (PV) in patients with ACS. We therefore evaluated the impact of MMPs on coronary PV as a post hoc analysis from the JAPAN-ACS study.

Methods: The multicenter JAPAN-ACS trial revealed that aggressive statin therapy for patients with ACS significantly reduces coronary PV determined by intravascular ultrasound (IVUS). We studied 248 ACS patients who had serial IVUS examinations over 8-12 months in the trial. For each patient, MMP-1, 2, and 3 were measured both at baseline and at study end to evaluate the correlation between the percent change of PV and MMP levels.

Results: MMP-3 levels were significantly decreased during the follow-up period (100 ng/mL to 73 ng/mL, p < 0.001), in contrast, MMP-1, -2 levels were significantly increased. MMP-3 levels at follow-up correlated with coronary plaque regression (p for trend = 0.016). A multivariable linear regression model showed both MMP-2 and MMP-3 levels at follow-up were independent variables for change of coronary PV (p = 0.038 and p = 0.016, respectively).

Conclusion: Circulating MMPs levels are associated with changes in coronary plaque volume determined by serial IVUS in patients with ACS.

Publication types

  • Multicenter Study

MeSH terms

  • Acute Coronary Syndrome / blood*
  • Acute Coronary Syndrome / complications
  • Acute Coronary Syndrome / drug therapy*
  • Atorvastatin
  • Coronary Artery Disease / blood*
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / drug therapy*
  • Female
  • Heptanoic Acids / therapeutic use*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Male
  • Matrix Metalloproteinases / blood*
  • Middle Aged
  • Plaque, Atherosclerotic / blood*
  • Plaque, Atherosclerotic / complications
  • Plaque, Atherosclerotic / drug therapy*
  • Plaque, Atherosclerotic / pathology
  • Prospective Studies
  • Pyrroles / therapeutic use*
  • Quinolines / therapeutic use*
  • Remission Induction

Substances

  • Heptanoic Acids
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Pyrroles
  • Quinolines
  • Atorvastatin
  • Matrix Metalloproteinases
  • pitavastatin