QJM Advance Access published online on August 1, 2008
QJM, doi:10.1093/qjmed/hcn088
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Serum matrix metalloproteinase-9 and coronary heart disease: a prospective study in middle-aged men
From the 1Division of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, 2Division of Community Health Sciences, St George's, University of London, London and 3Department of Primary Care and Population Sciences, Royal Free and University College London Medical School, London
Address correspondence to Prof. Gordon D.O. Lowe, Division of Cardiovascular and Medical Sciences, University of Glasgow, Queen Elizabeth Building, Royal Infirmary, 10 Alexandra Parade, Glasgow G31 2ER. email: g.d.lowe{at}clinmed.gla.ac.uk
Received 8 April 2008 and in revised form 2 July 2008
 |
Abstract |
|---|
Background: Matrix metalloproteinase-9 (MMP-9) has a potential role in arterial plaque rupture, but its relation to risk of coronary heart disease (CHD) is uncertain.
Aim: To determine whether circulating levels of serum MMP-9 are prospectively related to the risk of CHD in the general population.
Methods: We measured baseline MMP-9 levels in stored serum samples of subjects in a case-control study nested within a prospective study of 5661 men followed up for 16 years for CHD events (465 cases, 1076 controls).
Results: MMP-9 values were associated with cigarette smoking, and with several inflammatory and haemostatic markers, but not with age, body mass index, blood pressure or lipid measurements. Men in the top third of baseline MMP-9 levels had an age-adjusted odds ratio (OR) for CHD of 1.37 (95% CI 1.04–1.82) compared with those in the bottom third. Adjustment for conventional risk factors (smoking in particular) reduced the odds ratio to borderline significance: OR 1.28 (95% CI 0.95–1.74), while additional adjustment for two markers of generalized inflammation, interleukin-6 and C-reactive protein, further attenuated the association: OR 1.13 (0.82–1.56).
Conclusion: Serum MMP-9 has a modest association with incident CHD in the general population, which is not independent of cigarette smoking exposure and circulating markers of generalized inflammation. MMP-9 is unlikely to be a clinically useful biomarker of CHD risk, but may still play a role in the pathogenesis of CHD.