Relationships between markers of extracellular matrix degradation and systemic inflammatory response among patients with acute myocardial infarction

  • E. V. Sid State institution "Zaporizhia Medical Academy of Post-Graduate Education Ministry of Health of Ukraine"
  • V. V. Litvinenko State institution "Zaporizhia Medical Academy of Post-Graduate Education Ministry of Health of Ukraine"
Keywords: matrix metalloproteinase-9, tissue inhibitor of matrix metalloproteinase-2, acute myocardial infarction


Despite all the preventive, diagnostic and therapeutic possibilities of our time, diseases of the circulatory system are the leading causes of death among adult population both in the world and in Ukraine. Modern consensuses of the European society of Cardiology have recommendations with many years of based-on-evidence experience in the diagnosis of acute myocardial infarction. They note that biomarkers of myocardial necrosis must meet modern requirements of accuracy, reproducibility, and especially sensitivity and specificity. Now, together with classical markers of heart muscle damage, markers reflecting various pathogenetic directions of acute myocardial infarction are increasingly used in clinical practice; they include markers of myocardial dysfunction and markers of inflammatory process activation.

Purpose of the study. Identify relationships between markers of the extracellular matrix degradation and systemic inflammatory response among patients with acute myocardial infarction. Materials and methods. Results of the study are based on data from a comprehensive survey of 305 IHD patients: 162 patients with STEMI, 81 individuals with NSTEMI, and the control group consisted of 62 patients with angina pectoris (functional class II and III for 31 people). The sample of patients was carried out in the period from 2015 to January 2018 on the basis of MI «Regional medical center of cardiovascular diseases» of the Zaporizhzhia regional Council. All 305 surveyed people were comparable in age, social status, and gender (with the ratio of men to women was 4 to 1).

Results and discussion. The highest level of HS-CRP was in the group of STEMI patients and amounted to 10,91 (9,40–13,43) mg/l and significantly exceeded by 24% the level of this indicator in the group of NSTEMI patients – 8,80 (7,05–10,91) mg/l, (p < 0,05). The level of TNF-αwas significantly higher in the STEMI group of 2,10 (1,53–2,86) pg/ml versus 1,67 (1,09–2,20) pg/ml in the NSTEMI group of patients, (p < 0,05) and the leap rate was 2,4 times higher than the level of 0,89 (0,67–1,55) pg/ml in the group of patients with stable IHD (p < 0,05). In both groups of AMI patients with both STEMI and NSTEMI, there was a significant increase in IL-6 levels compared to the group of patients with stable IHD, where this indicator was 2,26 (1,22–3,66) pg/ml, 5 and 3,2 times, respectively (p < 0,05). The IL-6/IL-10 ratio in the STEMI and NSTEMI groups was 2,78 (1,72–4,68) versus 1,82 (1,49–2,36), respectively, and was significantly 50,8% higher (p < 0,05). Reliable direct links were found between: the levels of MPP-9 and HF-CRP (R = +0,61, p = 0,001), the levels of MPP-9 and TNF-α (R = +0,62, p = 0,001), the level of MPP-9 and the IL-6/IL-10 ratio, the levels of TIMP-2 and CRP (R = +0,50, p = 0,001).


Oras A, Tomas J, Mar P-R et al. Statistics on mortality following acute myocardial infarction in 842-897 Europeans. Cardiovascular Research. 2020; 116 (1): 149–157. DOI: 10.1093/cvr/cvz197.

Takuma T, Koki S, Takahiro Hі et al. Impact of Late Ventricular Arrhythmias on Cardiac Mortality in Patients with Acute Myocardial Infarction. Journal of Interventional Cardiology. 2019; 2019: 1–9. DOI: 10.1155/2019/5345178.

Kingma JG. Myocardial Infarction: An Overview of STEMI and NSTEMI Physiopathology and Treatment. World Journal of Cardiovascular Diseases. 2018; 8 (11): 498–517. DOI: 10.4236/wjcd.2018.811049.

Mack M, Gopal A. Epidemiology, traditional and novel risk factors in coronary artery disease. Heart failure clinics. 2016; 12 (1): 1–10. DOI: 10.1016/j.ccl.2014.04.003.

Bencsik P, Sasi V, Kiss K et al. Serum lipids and cardiac function correlate with nitrotyrosine and MMP activity in coronary artery disease patients. European journal of clinical investigation. 2015; 45 (7): 692–701. DOI: 10.1111/eci.12458.

Zhu JJ, Zhao Q, Qu HJ et al. Usefulness of plasma matrix metalloproteinase-9 levels in prediction of in-hospital mortality in patients who received emergent percutaneous coronary artery intervention following myocardial infarction. Oncotarget. 2017; 8 (62): 105809–105818. DOI: 10.18632/oncotarget.22401.

Seropian IM, Sonnino C, Van Tassell BW et al. Inflammatory markers in ST-elevation acute myocardial infarction. European Heart Journal: Acute Cardiovascular Care. 2016; 5 (4): 382–395. DOI: 10.1177/2048872615568965.

Fang L, Moore XL, Dart AM et al. Systemic inflammatory response following acute myocardial infarction. Journal of Geriatric Cardiology. 2015; 12 (3): 305–312. DOI: 10.11909/j.issn.1671-5411.2015.03.020.

Thygesen K, Alpert JS, Jaffe AS et al. Third universal definition of myocardial infarction. Eur Heart J. 2012; 33 (20): 2551–2567. DOI: 10.1093/eurheartj/ehs184.

Thygesen K, Alpert JS, Jaffe AS et al. Fourth universal definition of myocardial infarction (2018). Eur Heart J. 2019; 40 (3): 237–269. DOI: 10.1093/eurheartj/ehy462.

Hamed GM, Fattah MF. Clinical relevance of matrix metalloproteinase 9 in patients with acute coronary syndrome. Clinical and Applied Thrombosis/Hemostasis. 2015; 21 (8): 705–711. DOI: 10.1177/1076029614567309.

Owolabi US, Amraotkar AR, Coulter AR et al. Change in matrix metalloproteinase 2, 3, and 9 levels at the time of and after acute atherothrombotic myocardial infarction. Journal of Thrombosis and Thrombolysis. 2020; 49 (2): 235–244.

Prabhu SD, Frangogiannis NG. The biological basis for cardiac repair after myocardial infarction: from inflammation to fibrosis. Circulation research. 2016; 119 (1): 91–112. DOI: 10.1161/CIRCRESAHA.116.303577.

Zarrouk-Mahjoub S, Zaghdoudi M, Amira Z etal.Pro-andanti-inflammatorycytokines in post-infarction left ventricular remodeling. International journal of cardiology. 2016; 221: 632–636. DOI: 10.1016/j.ijcard.2016.07.073.

Suryana K, Wita W, Widiana IG et al. Low II-10 Plasma Levels, High II-6/II-10 Ratio and Matrix Metalloproteinase-9 (MMP-9) Associated With High Cardiovascular Events in Acute Coronary Syndrome. Biomedical and Pharmacology Journal. 2017; 10 (3): 1229–1238. DOI: 10.13005/bpj/1225.

How to Cite
Sid, E. V., & Litvinenko, V. V. (2020). Relationships between markers of extracellular matrix degradation and systemic inflammatory response among patients with acute myocardial infarction. Modern Medical Technology, (1(44), 25-31.
Original research