Prognostic impact of serum matrix metalloproteinase-3 in patients with idiopathic dilated cardiomyopathy

Abstract

Hypothesis: We hypothesized that increased matrix metalloproteinases (MMPs) activity could be associated with higher incidence of future cardiac events of patients with idiopathic dilated cardiomyopathy (DCM), and evaluated the prognostic ability of serum MMPs compared with other prognostic predictors in DCM. Methods: We measured serum levels of MMP-2, MMP-3, and MMP-9 using ELISA in 35 patients with DCM and 20 healthy control subjects. Moreover, plasma levels of high sensitive C-reactive protein, norepinephrine, and brain natriuretic peptide (BNP) were also measured. The primary end point was the composite incidence of cardiac death and hospitalizations for worsening heart failure. Results: Serum levels of MMP-2, MMP-3, and MMP-9 were significantly higher in patients with DCM than in control subjects (all p < 0.05). During the mean follow-up periods of 25 ± 12 months, 7 patients had major cardiac events; sudden cardiac death in 2 and hospitalizations for worsening heart failure in 5. On multivariate analysis of six markers, only plasma BNP and serum MMP-3 were significant independent predictors of cardiac events in patients with DCM (p = 0.015 and p = 0.026, respectively). According to the Kaplan-Meier analysis, cardiac event-free rates were significantly lower in high MMP-3 group (MMP-3 > 55 ng/ml) than in low MMP-3 group (MMP-3 < 55 ng/ml) (p = 0.027). Conclusions: Our study may address the capability of serum MMP-3 for predicting the prognosis of patients with DCM.