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Published on: January 28, 2020
Extracellular Matrix Remodeling Biomarkers in Coronary Artery Disease
Panagiotis Theofilis1, Marios Sagris1, Evangelos Oikonomou1,2
11st Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece.
Insights
Matrix metalloproteinases (MMPs) are linked to atherosclerosis and coronary artery disease. Elevated MMP levels indicate increased cardiovascular risk and disease severity, aiding in diagnosis and prognosis.
Area of Science:
- Cardiovascular Medicine
- Biomarkers
- Extracellular Matrix Biology
Background:
- Atherosclerosis and coronary artery disease (CAD) are leading causes of global mortality.
- Extracellular matrix (ECM) remodeling, involving ECM component cleavage and inflammation, is central to CAD pathophysiology.
- Early detection and comprehensive management strategies for CAD are crucial.
Purpose of the Study:
- To review the role of ECM degradation indicators, particularly matrix metalloproteinases (MMPs), in the context of coronary artery disease.
- To explore the correlation between specific MMPs and cardiovascular risk factors, disease severity, and prognosis.
- To highlight the potential of ECM biomarkers in identifying individuals at risk for CAD and informing patient care.
Main Methods:
- Review of clinical studies investigating ECM degradation indicators in cardiovascular disease.
- Analysis of the association between matrix metalloproteinases (MMP-1, MMP-2, MMP-8, MMP-9) and cardiovascular risk factors (metabolic syndrome, obesity, dyslipidemia, diabetes, smoking).
- Comparison of MMP concentrations in patients with acute coronary syndromes, stable angina, and healthy controls.
Main Results:
- Elevated levels of MMP-1, MMP-2, MMP-8, and MMP-9 are observed in patients with cardiovascular risk factors.
- Increased MMP concentrations are detected in acute coronary syndromes compared to stable angina and healthy individuals.
- High concentrations of these ECM biomarkers are also found in other vascular pathologies, including peripheral artery disease and aortic aneurysms.
Conclusions:
- Matrix metalloproteinases show significant association with cardiovascular risk factors and coronary artery disease severity.
- ECM biomarkers hold promise for improving the identification of individuals at risk for developing overt coronary artery disease.
- Further research is needed to establish the clinical utility of these biomarkers for risk stratification and prognosis in CAD patients.
Abstract:
Atherosclerosis and one of its most serious consequences, coronary artery disease, are important sources of morbidity and mortality globally, necessitating early detection and treatment. Considering their complex pathophysiology, including several harmful processes, a comprehensive approach to diagnosis, prognosis, and therapy is very desirable. Extracellular matrix remodeling is a major component of this dangerous cascade, including the cleavage of constituents (collagen, elastin, proteoglycans) and the propagation or exacerbation of the inflammatory response. Several extracellular matrix degradation indicators have been hypothesized to correlate with the existence, severity, and prognosis of coronary artery disease. The potency of matrix metalloproteinases, notably collagenases and gelatinases, has been the most thoroughly investigated in clinical studies. Stromelysins, matrilysins, transmembrane matrix metalloproteinases, collagen and laminin turnover indicators, as well as fibronectin, have also been studied to a lesser level. Among the most well-studied markers, MMP-1, MMP-2, MMP-8, and MMP-9 have been found increased in patients with cardiovascular risk factors such as metabolic syndrome, its components (obesity, dyslipidemia, diabetes mellitus), and smoking. Increasing concentrations are detected in acute coronary syndromes compared to stable angina pectoris and healthy control groups. It should also be stressed that those extracellular matrix biomarkers may also be detected in high concentrations in other vascular pathologies such as peripheral artery disease, carotid artery disease, aortic aneurysms, and dissections. Despite the advances gained, future research should focus on their importance and, more crucially, their added utility as biomarkers in identifying persons at risk of developing overt coronary artery disease. At the same time, determining the prognosis of coronary artery disease patients using such biomarkers may be important for their adequate care.
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