Poorly controlled diabetes mellitus type 2 is associated with increased mmp-9 levels and occurance of myocardial infarction-a pilot study

Background: Acute coronary events are seen to be more in Diabetes mellitus (DM) type 2 patients and the etiopathogenesis of this increased atherothrombogenesis is under research.Advanced glycation end products (AGEs) hallmark of DM may increase matrix metalloproteinase which are involved with instability of atherosclerotic plaque.
Aims and Objectives:To evaluate levels of MMP-9 in Acute myocardial infarction (AMI) patients without DM and in (AMI) patients with DM and volunteers with DM and volunteers without DM, and to correlate it with occurance AMI.
Method and Results: Diagnosed patients of AMI without DM ( n=30) and patients of AMI with DM (of atleast 10 years of duration) (n=30) were enrolled from cardiology department, G. B. Pant Hospital, New Delhi as cases, with age and sex matched controls without DM (n=30) and with DM (n=30) after informed consent.2 ml blood was collected in plain vial for routine biochemical investigations by automated methodologies and plasma MMP-9 levels was estimated using RayBio Human MMP-9 ELISA Kit.We found MMP-9 levels in patients having AMI without DM ( 22.2 ± 1.2 ng/ml)was significantly more (p-value <0.001) than in healthy volunteers without DM (21.5 ± 1.2ng/ml).We also found MMP-9 levels in patients having AMI with DM ( 24.1 ± 1.1 ng/ml)was significantly more (p-value <0.001) than in healthy volunteers with DM (22.4 ± 1.5 ng/ml). And MMP-9 levels in AMI patients with DM were found to be significantly more than in MMP-9 levels in patients without DM.
Conclusion: AGEs of DM (↑↑Glycated hemoglobin) is associated with increased levels of MMP-9 in AMI patients particularly in poorly controlled DM and appear congruent with the etiopathogenesis of vulnerable plaque. However, large scale studies are needed to ascertain its significance in AMI with DM.