The aim of this review was to analyse the scientific literature data on matrix metallopeptidase 9 and to analyse the available information on its prognostic value as a marker of negative outcome in the short- and long-term prognosis in patients with acute coronary syndrome. Materials and methods. In our study was used a recursive literature search strategy at PubMed. The following criteria for inclusion in the analysis were defined – a prospective study in patients with acute coronary syndrome that had data on the effect of MMP-9 levels on short-term and/or long-term outcomes, including mortality and major adverse сardiovascular events. Review articles, clinical cases, animal studies, and studies with insignificant statistical data were not included in the analysis. The depth of the initial search was set at 15 years with a search for similar articles in citations. We selected 5 studies for meta-analysis. Meta-Essentials 1.5 was used for the analysis. Odds ratio and 95 % confidence interval were calculated using the Haenszel method. The association between MMP-9 levels and short-term and long-term outcomes (mortality and major adverse CV events) was determined. The statistically significant level was defined as P < 0.05. Results. The analysis showed no significant association between the level of MMP-9 and the outcome (OR = 1.39; 95 % CI = 0.25–7.79; P = 0.595; I2 = 78 %). Conclusions. Matrix metallopeptidase 9 is a promising marker for further investigation of its predictive strength of outcome. Despite the opposite results of single studies and no significant association of MMP-9 with outcome further research on this issue is a promising direction.

Elevated levels of several inflammatory cytokines and chemokines, such as myeloperoxidase (MPO) and some characteristics of damaged myocardium such as myocardial deformation (global longitudinal strain — GLS) seem to be promising biomarkers for acute coronary syndrome, but their predictive ability for clinical outcomes amongst ST segment elevation myocardial infarction (STEMI) patients having obesity remained unclear. The aim of the study was to to determine the impact of MPO and GLS on prediction of 1‑year combined clinical events in STEMI patients successfully treated with primary percutaneous coronary intervention (PCI) depending on abdominal obesity presentation. Materials and methods. We prospectively enrolled 102 individuals with STEMI who were successfully treated with primary PCI. All patients gave their consent to participate in the study. The biomarkers (MPO, cardiac troponins), echocardiographic and Doppler parameters including global longitudinal strain (GLS) were evaluated at the baseline. Results. The MPO level in the entire population of patients with STEMI was 129.45 [48.48 — 179.70] ng/ml. The group was divided into two cohorts depending on the median level of MPO (≥ 98.34 ng/ml and < 98.34 ng/ml). We observed 26 combined end‑points (10 and 17 in patients with MPO ³ 98.34 ng/ml and < 98.34 ng/ml, respectively (F test = 0.064285; ε2 = 4.29; р = 0.046). Multivariate linear regression showed that the only GLS and MPO remained independent predictors for the clinical outcomes. Conclusions. Global longitudinal strain was the best predictor for 1‑year combined clinical outcomes in STEMI patients who were undergone successful primary PCI. Body fat accumulation seems to show borderline significance when compared with GLS, while it was sufficiently better than MPO.

Objective — to determine the most important markers for predicting of the development of prediction of adverse left ventricular (LV) remodeling in patients within 1 year after acute ST‑segment elevation myocardial infarction (STEMI). Materials and methods. The study involved 134 patients with acute STEMI, 95 (70.9 %) men and 39 (29.1 %) women, who satisfied inclusion criteria and had no exclusion criteria. All of them were hospitalized in the emergency department of L.T. Mala National Therapy Institute of NAMS of Ukraine from January 2018 to February 2021. All patients underwent myocardial revascularization by percutaneous coronary intervention (PCI) within 2 — 12 hours after the event in the V. T. Zaytsev Institute of General and Emergency Surgery. TIMI — 3 flow was restored in all 134 patients. Within 1 — 3 days after revascularization patients were transferred to the research center. Late adverse LV remodeling was defined as elevated LV end diastolic volume (LVEDV) > 10 % and/or LV end systolic volume (LVESV) > 10 % within 1 year after the index event. Serum soluble tumor suppressor‑2 (sST2) levels were determined by enzyme‑linked immunosorbent assay (Presage ST2 Assay, Critical Diagnostics, USA), N‑Terminal Pro‑Brain Natriuretic Peptide (NT‑proBNP) was detected by R&D Systems GmbH, Wiesbaden‑Nordenstadt, Germany), macrophage inhibitory factor (MIF) in blood serum serum was determined by enzyme‑linked immunosorbent assay RayBio®Human MIF ELISA KIT, USA). Statistical analysis was performed using Statistica 8.0 (Stat Soft Inc, USA). Results. Patients were divided into two groups: group 1 included 48 patients with adverse LV remodeling and group 2 consisted of 86 patients without LV remodeling. Uni‑ and multivariate log‑regression analysis demonstrated that LV ejection fraction (EF), MIF, number of damaged coronary vessels, sST2, longitudinal strain were independent predictors of adverse LV remodeling. Analysis of ROC curves showed that the cumulative value of markers such as MIF, ST2, longitudinal strain, number of damaged vessels, LV ejection fraction (AUC = 0.718; p < 0.0001, 95 %, CI 0.634 — 0.792) allows to identify patients with high risk of the development of adverse LV remodeling in patients within 1 year after acute STEMI. The formula with these markers was found out, that can be used to predict adverse LV remodeling: the prognosis of positive effect at Y ≥ 0.5, negative — at Y < 0.5. Conclusions. The study results demonstrated that LV ejection fraction, MIF, number of damaged coronary arteries, sST2, and global longitudinal strain can be used as predictors of adverse LV remodeling.

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