TIME-DEPENDENT ALTERATIONS OF SERUM MATRIX METALLOPROTEINASE-1 AND METALLOPROTEINASE-1 TISSUE INHIBITOR AFTER SUCCESSFUL REPERFUSION OF ACUTE MYOCARDIAL-INFARCTION

Objective-To test the hypothesis that changes in serum matrix metallop roteinase-1 (MMP-1) and tissue inhibitors of metalloproteinase-1 (TIMP -1) after acute myocardial infarction reflect extracellular matrix rem odelling and the infarct healing process. Patients-13 consecutive pati ents with their first acute myocardial infarction who underwent succes sful reperfusion. Methods-Blood was sampled on the day of admission, a nd on days 2, 3, 4, 5, 7, 14, and 28. Serum MMP-1 and TIMP-1 were meas ured by one step sandwich enzyme immunoassay. Left ventricular volume indices were determined by left ventriculography performed four weeks after the infarct. Results-Serum concentrations of both MMP-1 and TIMP -1 changed over time. The average serum MMP-1 was more than 1 SD below the mean control values during the initial four days, increased there after, reaching a peak concentration around day 14, and then returned to the middle control range. Negative correlations with left ventricul ar end systolic volume index and positive correlations with left ventr icular ejection fraction were obtained for serum MMP-1 on day 5, when it began to rise, and for the magnitude of rise in MMP-1 on day 5 comp ared to admission. Serum TIMP-1 at admission was more than 1 SD below the mean control value, and increased gradually thereafter, reaching a peak on around day 14. Negative correlations with left ventricular en d systolic volume index and positive correlations with left ventricula r ejection fraction were obtained for serum TIMP-1 on days 5 and 7, an d for the magnitude of rise in TIMP-1 on days 5 and 7 compared to admi ssion. Conclusions-Both MMP-1 and TIMP-1 showed significant time depen dent alteration after acute myocardial infarction. infarction. Thus MM P-1 and TIMP-1 may provide useful information in evaluating the healin g process as it affects left ventricular remodeling after acute myocar dial infarction.