The Serum Levels Of MMP-12 And TIMP-1 In Patients With Acute Coronary Syndrome In The Progress Of Revascularization

Objective:To investigate the dynamic changes and significance of serum levels of MMP-12 and TIMP-1 at 24 hours,48 hours and 72 hours after revascularization in patients with acute coronary syndrome.The correlation between the serum levels of MMP-12 and TIMP-1 and LVEF,LVEDV,SYNTAX score and GRACE score was also investigated.Methods:A total of 80 ACS patients undergoing PCI were selected in the period from July 2016 to January 2019 at the First Affiliated Hospital of Kunming Medical University,including 38 patients with STEMI,20 patients with NSTEMI and 22 patients with UA.17 adults with normal coronary angiography were selected as control group from volunteers in our hospital.Blood samples of the ACS group was collected before operation and 24 hours,48 hours,and 72 hours after operation.Blood samples of the control group was collected before operation.The serum levels of MMP-12 and TIMP-1 at different time points was detected by Flexible Multi-analyte Profiling(xMAP).Results:1.The serum levels of MMP-12 and TIMP-1 in the STEMI group before PCI were significantly higher than those in the control group(1445.51±332.07pg/ml vs 686.58±151.90pg/ml,116985.03±56110.12pg/ml vs 30906.84±7307.72 pg/ml,P<0.05,<0.001,respectively),the difference is statistically significant.The serum levels of TIMP-1 in NSTEMI group was significantly higher th-an that in control group(76845.50±24692.20pg/ml vs 30906.84±7307.72pg/ml,P<0.05),and the difference was statistically significant.The serum levels of TIMP-1 in STEMI group was significantly higher than that in UA group(116985.03±56110.12pg/ml vs 61488.14±25197.31pg/ml,P<0.001),and the difference was statistically significant.The serum levels of TIMP-1 in STEM I group was significantly higher than that in NSTEMI group(116985.03±56110.12 pg/ml vs 76845.50±24692.20pg/ml,P<0.05),and the difference was statistically significant.2.The serum levels of MMP-12 in ACS patients with PCI after 24hours,48 hours and 72 hours compared with before treatment of PCI,the serum levels of MMP-12 were decreased,the difference was statistically significant(P<0.001).With the progress of STEMI,the serum levels of MMP-12 decreased rapidly from pre-operation to 24 hours after PCI,and then dropped to the lowest point at 24-72 hours.With the progress of NSTEMI and UA,the serum levels of MMP-12 decreased rapidly from pre-operation to 24 hours after PCI,gradually decreased to the trough at 24 hours after PCI and gradually increased at 48-72 hours after PCI.3.The serum levels of TIMP-1 in STEMI group,NSTEMI group and UA group at 24 hours,48 hours and 72 hours after PCI were higher than those before PCI(P>005),and there was no significant difference between the two groups.With the progress of STEMI and NSTEMI,the serum levels of TIMP-1 gradually increased to peak at 24 hours after PCI and decreased gradually from 48 hours to 72 hours after PCI.With the progress of UA,the serum level of TIMP-1 gradually increased at 24-72 hours after operation.4.There was no statistically significant between the serum levels of MMP-12 in ACS patients and LVEF,LVEDV,SYNTAX scores and GRACE score.The serum levels of MMP-12 in ACS patients after 72 hours of PCI were positively correlated with LVEDV,the difference was statistically(P<0.05).5.The serum levels of TIMP-1 in ACS patients were negatively correlated with LVEF and LVEDV,the difference was statistically(P<0.05).The serum levels of TIMP-1 in ACS patients were positively correlated with SYNTAX scores and GRACE scores,the difference was statistically(P<0.05).There was no statistically significant between the serum levels of TIMP-1 after 24 hours of PCI and SYNTAX scores.There was no statistically significant between the serum levels TIMP-1 after 72 hours of PCI and GRACE scores.Conclusions:1.The serum levels of MMP-12 and TIMP-1 in the ACS group before PCI were higher than those with normal coronary angiography in the control group.MMP-12 and TIMP-1 may be involved in the instability of atherosclerotic plaque and the formation of thrombosis in patients with acute coronary syndrome.2.The serum levels of MMP-12 in ACS patients were decreased after revascularization compared with before treatment.The serum levels of TIMP-1 in ACS patients were increased after revascularization compared with before treatment.3.The serum levels of TIMP-1 in ACS patients were negatively correlated with LVEF and LVEDV.The serum levels of TIMP-1 may be involved in left ventricular functional changes from 0 hours to 72 hours after PCI in ACS patients.4.The serum levels of TIMP-1 in ACS patients were positively correlated with SYNTAX scores and GRACE scores.The serum levels of TIMP-1 may be related to the severity of coronary lesions and the prognosis of patients.