Correlation Between MMP-3,TIMP-1 And Myocardial Injury Before And After Coronary Artery Revascularization

Objective: To investigate the changes of serum MMP-3 and TIMP-1 expression levels before and after coronary artery revascularization and the correlation between these changes and myocardial injury.The aim of this study is to explore new early-warning molecules of myocardial injury during perioperative period after coronary artery revascularization,so as to provide theoretical basis and experimental basis for promoting early diagnosis and intervention of myocardial injury.Methods: Patients with coronary heart disease who underwent coronary artery revascularization in the Department of Cardiothoracic Surgery,Guangzhou Red Cross Hospital Affiliated to Jinan University from September 2019 to December 2020 were collected as the research subjects,and were divided into CABG group and PCI group(30cases in each group)according to the operation method.Blood samples were collected 12 hours before surgery,12 hours after surgery,1 day after surgery and 3 days after surgery,and 30 healthy control patients were collected at the same period.Serum troponin I(c Tn I)was measured by enzyme-linked immunosorbent assay and immunofluorescence assay,respectively.The activity of serum MMP-3 was detected by casein enzyme spectrometry,and the results were analyzed statistically.The correlation of MMP-3,TIMP-1 and c Tn I in CABG group and PCI group at four different time points before and after operation was analyzed.Results: There were no significant differences in age,sex,smoking,hypertension,diabetes,hyperlipidemia,fatty liver,previous myocardial infarction,mean left ventricular ejection fraction and angiopathy between the coronary artery revascularization group and the control group(P>0.05).The expression of MMP-3 in serum of CABG group and PCI group before operation was significantly higher than that of normal control group(P<0.05).The expression of TIMP-1 in serum of CABG group and PCI group before operation was significantly lower than that of normal control group(P<0.05).The zymogram analysis of CABG group and PCI group showed that the most obvious band was observed at MMP-3.The zymogram analysis of CABG group and PCI group showed that the most obvious band was observed at MMP-3.In CABG group,compared with that before operation,the expression of MMP-3 increased after operation,and reached the highest on the first day after operation,and there was a strong positive correlation between MMP-3and c Tn I at four different time points before and after operation(r=0.602,P<0.001;r=0.563,P=0.001;r=0.693,P<0.001;r=0.496,P=0.005).In CABG group,compared with that before operation,the expression of TIMP-1 decreased after operation and reached the lowest on the first day after operation,and there was a strong negative correlation between TIMP-1 and c Tn I at four different time points before and after operation(r=-0.581,P<0.001;r=-0.565,P=0.001;r=-0.533,P=0.002;r=-0.522,P=0.003).In PCI group,compared with that before operation,the expression of MMP-3 increased after operation,and reached the highest on the first day after operation,and there was a strong positive correlation between MMP-3 and c Tn I at four different time points before and after operation(r=0.629,P<0.001;r=0.676,P<0.001;r=0.731,P<0.001;r=0.547,P=0.002).In PCI group,compared with that before operation,the expression of TIMP-1 decreased after operation and reached the lowest on the first day after operation,and there was a strong negative correlation between TIMP-1 and c Tn I at four different time points before and after operation(r=-0.731,P<0.001;r=-0.627,P<0.001;r=-0.758,P<0.001;r=-0.682,P<0.001).Conclusions:There were statistically significant differences in the serum expression levels of MMP-3 and TIMP-1 in the patients with coronary revasculation compared with the normal control group before surgery,and there were statistically significant differences in the serum expression levels after surgery compared with that before surgery(P <0.05).MMP-3 showed high enzyme activity after coronary artery revascularization,suggesting that the production of MMP-3 may be related to the physiological and pathological process of myocardial injury.There was a positive correlation between MMP-3 and c Tn I in CABG group and PCI group during the perioperative period,and a negative correlation between TIMP-1 and c Tn I in CABG group and PCI group during the perioperative period.Both of them can reflect the myocardial injury and changes of patients after coronary revascularization to a certain extent.Combined with c Tn I,the two can determine the severity of myocardial injury,which is of great significance in the timely intervention and treatment of postoperative myocardial injury.MMP-3 and TIMP-1 may be a new potential biological indicator to reflect the degree of myocardial injury before and after coronary artery revasvarization,which has clinical value both for patients with coronary heart disease during perioperative period and for auxiliary examination of myocardial injury,and can help more detailed patients with coronary heart disease to prevent the risk of postoperative myocardial injury and intervention.