The Effects of Percutaneous Coronary Intervention (PCI) on Levels of MMP-9, sST2, NT-pro BNP, and Quality of Life in Patients with Chronic Total Coronary Artery Obstruction (Preprint)

Abstract

BACKGROUND Chronic total occlusion (CTO) is an angiographic picture of total occlusion without blood flow which is estimated to have lasted at least three months. There is still controversy regarding the clinical outcome and quality of life between revascularization and medical therapy in CTO. OBJECTIVE This study attempted to provide an overview of the levels of MMP-9, sST2, and NT-pro BNP as remodeling, inflammatory, and atherosclerotic markers, as well as changes in the angina severity in patients with CTO who underwent percutaneous coronary intervention (PCI) compared to those without PCI. METHODS This is a Quasi-Experimental Design study with a pre-test and post-test approach to compare PCI's effect in CTO patients towards change in MMP-9, sST2, NT-pro BNP levels, and changes in the angina severity. Twenty subjects underwent PCI and 20 subjects with optimal medical therapy who were then assessed at baseline and eight weeks after intervention. RESULTS The results of this study showed that decreased MMP-9 (pre: 12.07±1.27 ng/ml vs. post: 9.91±5.19 ng/ml; p=0.049), sST2 (pre: 37.65±20.00 ng/ml vs. post: 29.74±15.17 ng/ml; p=0.026) and NT-pro-BNP (pre: 0.63±0.23 ng/ml vs. post: 0.24±0.10 ng/ml; p<0.001) levels were found after 8 weeks of PCI compared to those without such intervention. The levels of NT-pro BNP were lower in the PCI group (0.24±0.10 ng/mL) than in the non-PCI group (0.56±0.23 ng/ml; p<0.001). Moreover, there was an improvement of angina severity in PCI group than without PCI (p<0.039). CONCLUSIONS This study proves that PCI reduce MMP-9, NT-pro BNP, and sST2 levels and improve angina severity in CTO patients to a person without PCI.