The Correlation And Clinical Value Of Matrix Metalloproteinase 28 (MMP-28) With Acute Myocardial Infarction And Calcified Aortic Valve Stenosis

Background:(1)To investigate the relationship between the level of matrix metalloproteinase-28(MMP-28)in patients with acute myocardial infarction(AMI)and the global registry of acute coronary events(GRACE)scores as well as their short-term prognosis.(2)Calcific aortic valve disease(CAVD)is a common cardiovascular disorder worldwide.This study is to investigate the correlation between plasma matrix metalloproteinase-28(MMP-28)levels and the severity of calcific aortic valve stenosis(CAVS).Methods:(1)211 patients with AMI were enrolled and their basic clinical characteristics were collected for GRACE score.Then,we measured plasma levels of MMP-28 and other biomarkers in study population.The associations of MMP-28 levels with cardiac events and cardiac deaths occurring within 30 days of discharge were evaluated with multivariable Cox proportional hazard models.(2)CAVS patients who were admitted into the heart center of our hospital between January2016 and January 2019 to undergo surgery were successively enrolled in this study(55 males and 24 females with the average age of 58.5 ± 9.6).For retrospective analyses,we performed echocardiography on the patients,measured their plasma MMP-28 levels,and collected other clinical data.Results:(1)The levels of MMP-28 were significantly higher in patients with acute ST-elevation myocardial infarction(STEMI)than that in patients with non-ST-elevation myocardial infarction(NSTEMI)(P <0.01).Correlation analysis showed that the level of MMP-28 was positively correlated with GRACE score in patients with AMI(R2 = 0.366,P <0.05).Cox multivariate regression results showed that MMP-28 was associated with cardiovascular events during the hospitalization and 30 days after discharge(P <0.01).In addition,Kaplan-Meier analysis showed that cardiac events and deaths were significantly higher in patients with MMP-28 ?1.21ng/m L(all P<0.01).(2)The average plasma MMP-28 level was 2.43 ± 2.22ng/m L(range,0.22–8.27 ng/m L).The plasma MMP-28 levels in the patients with mild(n = 24),moderate(n = 31),or severe(n = 24)CAVS were 1.33 ± 1.47,2.04 ±1.85,and 4.02 ± 2.44 ng/m L,respectively,showing that the patients with severe CAVS had significantly higher MMP-28 levels than the patients with moderate or mild CAVS(both P < 0.01).Regression analysis by using the general linear model further revealed that plasma MMP-28 level was correlated with the peak blood flow velocity and mean pressure gradient of the transaortic valve,and the correlations were statistically significant(both P < 0.01).Conclusions:(1)There is a correlation between the plasma MMP-28 level and GRACE score in patients with AMI.MMP-28 is also associated with cardiovascular events and cardiovascular deaths during the patients' hospitalization and within 30 days after discharge.(2)MMP-28 level is significantly elevated in severe cases of CAVS.Moreover,plasma MMP-28 levels are positively associated with the mean pressure gradients and peak blood flow velocity of the trans-aortic valve.