Genetic polymorphisms of matrix metalloproteinase-9, tissue inhibitor of matrix metalloproteinase-1 and development of postoperative atrial fibrillation in elderly patients

Abstract

Abstract Purpose The aim of the study was to assess the association of genetic polymorphisms of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) with atrial fibrillation development in elderly patients with coronary artery disease (CAD), undergoing coronary artery bypass graft (CABG) surgery. Methods Studied were 80 patients who underwent CABG. In all the patients routine laboratory and instrumental tests were performed. Patients also underwent genetic polymorphisms of MMP-9 A8202G and TIMP-1 C536T estimation with polymerase chain reaction. According to occurrence of postoperative atrial fibrillation (POAF) all the patients were divided into two groups: group 1 – patients without POAF (56 patients, 81.8% males, mean age 65.9±4.0 years), group 2 – patients with first detected episode of AF after CABG (24 patients, 87.5% males, mean age 67.7±5.4). Results In group 1 the II grade of stable angina was significantly more often than in patients of the 2 group (32.1% vs 12.5%, p=0.009). Patients of the 2 group had more long history of CAD (87.2±72.4 months vs 46.9±31.4 months, p=0.03), more often – NYHA III (45.8% vs 12.5%, p=0.01) and larger LA diameter (43.8±3.5 mm vs 37.5±3.9 mm, p<0.001) than the patients of the 1 group. Genotype AA MMP-9 A8202G was found in 39.3% patients of the 1 group and in 16.7% patients of the 2 group (p=0.04), genotype AG – in 44.6% and 54.1% respectively (p=0.4), genotype GG – in 16.1% and 29.2% respectively (p=0.06). Genotype CC TIMP-1 C536T was found in 98.2% and 100% patients in 1 and 2 group respectively (p=0.72), genotype CT – in 1.8% patients of the 1 group. According to results of multivariate regression analysis odds ratio of POAF development in patients with stable angina grade III was 1.8 (95% CI 0.5–7.5, p=0.4), NYHA III – 0.85 (95% CI 0.2–3.5, p=0.55), history of CAD more than 20 months – 1.8 (95% CI 1.2–8.1, p=0.03), LA diameter more than 39 mm - 4.2 (95% CI 1.6–9.5, p<0.0001), allele G MMP-9 A8202G – 2.6 (95% CI 1.2–7.5, p=0.03). Conclusion In elderly patients undergoing coronary artery bypass graft surgery left atrial diameter more than 39 mm, history of coronary artery disease more than 20 months and the presence of G allele of MMP-9 A820G are significantly associated with postoperative atrial fibrillation development. Funding Acknowledgement Type of funding sources: None.