High plasma levels of tissue inhibitor of metalloproteinase-1 (TIMP-1) and interleukin-8 (IL-8) characterize patients prone to ventricular fibrillation complicating myocardial infarction

Elif Elmas 1 , 1 , Siegfried Lang 2 , 2 , Carl Erik Dempfle 3 , 3 , Thorsten Kälsch 4 , 4 , Dieter Hannak 5 , 5 , Tim Sueselbeck 6 , 6 , Christian Wolpert 7 , 7 , Martin Borggrefe 8 , 8  and Martina Brueckmann 9 , 9
  • 1 1st Department of Medicine, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
  • 2 1st Department of Medicine, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
  • 3 1st Department of Medicine, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
  • 4 1st Department of Medicine, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
  • 5 Institute of Clinical Chemistry, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
  • 6 1st Department of Medicine, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
  • 7 1st Department of Medicine, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
  • 8 1st Department of Medicine, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
  • 9 1st Department of Medicine, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany

Abstract

Background: Atherosclerotic plaques prone to cause thrombotic complications and plaque rupture account for the majority of fatal myocardial infarctions (MI), which may be complicated by ventricular fibrillation (VF). Matrix-degrading metalloproteinases (MMPs) and their inhibitors (TIMPs) are expressed in atherosclerotic lesions and contribute to plaque vulnerability. Interleukin-8 (IL-8) is one of the predominant chemokines interacting with MMPs and TIMPs and the coagulation system. The aim of the present study was to assess potential differences of levels of MMP-9, TIMP-1 and IL-8 in postmyocardial infarction patients with or without VF complicating acute MI.

Methods: Blood samples were taken from 45 patients with VF complicating acute MI and from 88 patients without VF. All samples were collected during a symptom-free interval remote from the acute ischemic event with a median of 556 days. The markers of interest were TIMP-1, MMP-9 and IL-8.

Results: IL-8 and TIMP-1 levels were significantly higher among patients with VF than among patients without VF (p<0.001). In a logistic regression approach IL-8 was an independent indicator of patients prone to VF during MI (p=0.03). High levels of TIMP-1 (p=0.05), MMP-9 (p=0.03), the MMP-9/TIMP-1 ratio (p=0.049) and hypertension (p=0.02) were found to be indicators in patients with reinfarction or unstable angina pectoris during follow-up. Hypertension (p=0.02) and MMP-9 (p=0.03) were the only significant indicators characterizing patients undergoing coronary reinterventions, such as percutaneous coronary interventions and coronary bypass surgery.

Conclusions: Higher TIMP-1 and IL-8 levels are present in patients with VF complicating MI. High TIMP-levels may be related to the degree of fibrosis which is a substrate for electrical instability and may contribute to the occurrence of VF. Patients prone to develop VF during MI seem to have an increased proinflammatory condition compared to patients without VF.

Clin Chem Lab Med 2007;45:1360–5.

Purchase article
Get instant unlimited access to the article.
$42.00
Log in
Already have access? Please log in.


or
Log in with your institution

Journal + Issues

Clinical Chemistry and Laboratory Medicine ( CCLM) publishes articles on novel teaching and training methods applicable to laboratory medicine. CCLM welcomes contributions on the progress in fundamental and applied research and cutting-edge clinical laboratory medicine. It is one of the leading journals in the field, with an impact factor of over three. CCLM is the official journal of nine national clinical societies and associated with EFLM.

Search