Predictive Utility of the Changes in Matrix Metalloproteinase‐2 in the Early Phase for Left Ventricular Reverse Remodeling After an Acute Myocardial Infarction

BACKGROUND The relationship between the serum levels of matrix metalloproteinase (MMP) and tissue inhibitors of MMP (TIMP) and left ventricular (LV) reverse remodeling (LV-RR) after an acute myocardial infarction (AMI) has not been sufficiently examined. METHODS AND RESULTS In 25 patients with successful reperfusion after an AMI and 15 normal control subjects, the serum MMP-2 and TIMP-2 levels were measured on days 1, 2, 3, and 7 and at 1 and 6 months after the AMI onset. LV-RR was defined as a >15% decrease in the LV end-systolic volume index at 6 months after the AMI. The MMP-2 level on day 1 and TIMP-2 levels throughout the study period were comparable between the patients with and without LV-RR. The MMP-2 on day 7 (P<0.05) and the changes in the MMP-2 from day 1 to day 7 (∆MMP-2; P<0.01) were lower in patients with than in those without LV-RR. The ∆MMP-2 was strongly correlated with the changes in the LV volume and ejection fraction from 1 month to 6 months after the AMI. The ∆MMP-2 value of <-158.5 ng/mL predicted LV-RR with a high accuracy (91.7% sensitivity and 76.9% specificity; area under the curve=0.82). CONCLUSIONS Changes in MMP-2 are associated with LV-RR after an AMI. The ΔMMP-2 might be a useful predictor of subsequent LV-RR.