THE MARKERS OF EXTRACELLULAR MATRIX DEGRADATION AS PREDICTORS OF THE  LEFT VENTRICULAR SYSTOLIC DYSFUNCTION AMONG PATIENTS AFTER PRIMARY  MYOCARDIAL INFARCTION

E. Sid’

Автор(и)

E. Sid’ State Institute «Zaporizhzhia Medical Academy of Postgraduate Education of Ministry of Health of Ukraine» https://orcid.org/0000-0001-9198-9640

Ключові слова:

acute myocardial infarction, matrix metalloproteinase-9, tissue inhibitor of matrix metalloproteinase-2, left ventricular systolic dysfunction

Анотація

The aim of the study. To determine the value of markers of extracellular matrix degradation as predictors of left ventricular systolic dysfunction among patients after primary myocardial infarction.

Materials and methods. The results of the study are based on data obtained from a comprehensive survey of 162 patients with acute myocardial infarction with stable ST segment elevation. The sample of patients was carried out in the period from 2015 to January 2018 on the basis of the the MI "Regional medical center of cardiovascular diseases" of the Zaporizhzhia regional Council. All persons were comparable in age, social status, and gender (the ratio of men to women was 4:1).

Obtained results. Significantly, the level of 5816.3 [5487.7 ; 6538.6] PG/ml of MPP-9 was higher in the LV EF group <45 % compared to 5129.6 [3984.6 ; 5975.8] PG/ml in the LV EF group >45 %, (p < 0.05). The level of TIMP-2 among patients with LV EF <45 % was 524.8 [484.6 ; 648.7] PG/ml and was considerably higher compared to 459.7 [368.3 ; 549.2] PG/ml in the LV EF group >45 %, (p < 0.05). The largest area under the ROC curve (AUC = 0.694, 95% CI 0.617-0.764) among the analyzed markers of extracellular matrix degradation was TIMP-2. At the cut-off point >483.7 PG/ml, the sensitivity was 76.47 % and the specificity was 62.07 % for LV systolic dysfunction among patients with STEMI.

The calculated relative risk for MPP-9 >5247.9 PG/ml for the development of left ventricular systolic dysfunction was 7,139, 95% CI 1,686-30,218. For the level of TIM-2 >483.7 PG/ml, the relative risk was 4,271, 95% CI 1,455-12,536 for the development of left ventricular systolic dysfunction.

Conclusions. Patients having STEMI with LV EF <45 % had essentially higher levels of MPP-9 and TIMP2. At the level of MPP-9 >5247.9 PG/ml, the relative risk of developing left ventricular systolic dysfunction among patients with STEMI increases by 7,139 times.