Matrix metalloproteinase-9 index as a possible parameter for predicting acute coronary syndrome in diabetics

Srdjan Popović; Fadil Canović; Miroljub Ilić; Sašo Rafajlovski; Vesna Dimitrijević-Srećković; Dragana Matanović; Svetlana Vujović; Predrag Djordjević; Draško Gostiljac

doi:10.2298/5448

Srdjan Popović Clinic for Endocrinology, Diabetes and Metabolic Diseases; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Fadil Canović Clinic for Endocrinology, Diabetes and Metabolic Diseases
Miroljub Ilić Clinic for Endocrinology, Diabetes and Metabolic Diseases
Sašo Rafajlovski Military Medical Academy, Belgrade, Serbia
Vesna Dimitrijević-Srećković Clinic for Endocrinology, Diabetes and Metabolic Diseases; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Dragana Matanović Clinic for Physical Medicine and Rehabilitation, Clinical Center of Serbia, Belgrade, Serbia
Svetlana Vujović Clinic for Endocrinology, Diabetes and Metabolic Diseases; Military Medical Academy, Belgrade, Serbia
Predrag Djordjević Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Draško Gostiljac Clinic for Endocrinology, Diabetes and Metabolic Diseases

DOI: https://doi.org/10.2298/5448

Keywords: diabetes mellitus, acute coronary syndrome, matrix metalloproteinase 9, prognosis,

Abstract

Background/Aim. Matrix metalloproteinase-9 (MMP-9) index is the ratio of active MMP-9 and total MMP-9 levels. It reflects the importance of MMP-9 in acute coronary syndrome (ACS). Methods. The study included 3 groups of patients (n = 87): the group 1 – non-diabetic subjects without ACS (control); the group 2 – diabetic patients with ACS [subgroups with unstable angina pectoris (UAP), myocardial infarction (MI) or reinfarction]; and the group 3 non-diabetics patients with ACS. Total and active MMP-9 were measured and used to create MMP-9 index. Results. MMP-9 index, as a marker showed good sensitivity and specificity, of ACS in diabetics, with a cut-off value over 58.2. MMP-9 was higher in the study groups than in the control one. MMP-9 correlated with ACS occurrence and type of cardiovascular event. A statistically significant difference was found among the groups according to active MMP-9 (p < 0.001). The same was found with active MMP-9 between the control and the group with MI (p < 0.001). The control was highly statistically significantly different from the group of patients with UAP (p < 0.01). Statically significant differences in MMP-9 index was found between the control and the diabetics with ACS (p < 0.001). Statistically significant difference of MMP-9 index was also found in the controls compared to the value in non-diabetic patients with ACS (p < 0.01). Conclusion. MMP-9 index may be a possible marker of atheromatous plaque rupture in diabetics.

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