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Caselli C, Di Giorgi N, Ragusa R, Lorenzoni V, Smit J, El Mahdiui M, Buechel RR, Teresinska A, Pizzi MN, Roque A, Poddighe R, Knuuti J, Schütte M, Parodi O, Pelosi G, Scholte A, Rocchiccioli S, Neglia D. Association of MMP9 with adverse features of plaque progression and residual inflammatory risk in patients with chronic coronary syndrome (CCS). Vascul Pharmacol 2022; 146:107098. [PMID: 36100166 DOI: 10.1016/j.vph.2022.107098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/18/2022] [Accepted: 08/26/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS MMP-9 is a predictor of atherosclerotic plaque instability and adverse cardiovascular events, but longitudinal data on the association between MMP9 and coronary disease progression are lacking. This study is aimed at investigating whether MMP9 is associated with atherosclerotic plaque progression and the related molecular basis in stable patients with chronic coronary syndrome (CCS). METHODS MMP9 serum levels were measured in 157 CCS patients (58 ± 8 years of age; 66% male) undergoing coronary computed tomography angiography at baseline and after a follow up period of 6.5 ± 1.1 years to assess progression of Total, Fibrous, Fibro-fatty, Necrotic Core, and Dense Calcium plaque volumes (PV). Gene expression analysis was evaluated in whole blood using a transcriptomic approach by RNA-seq. RESULTS At multivariate analysis, serum MMP9 was associated with annual change of Total and Necrotic Core PV (Coefficient 3.205, SE 1.321, P = 0.017; 1.449, SE 0.690, P = 0.038, respectively), while MMP9 gene expression with Necrotic Core PV (Coefficient 70.559, SE 32.629, P = 0.034), independently from traditional cardiovascular risk factors, medications, and presence of obstructive CAD. After transcriptomic analysis, MMP9 expression was linked to expression of genes involved in the innate immunity. CONCLUSIONS Among CCS patients, MMP9 is an independent predictive marker of progression of adverse coronary plaques, possibly reflecting the activity of inflammatory pathways conditioning adverse plaque phenotypes. Thus, blood MMP9 might be used for the identification of patients with residual risk even with optimal management of classical cardiovascular risk factors who may derive the greatest benefit from targeted anti-inflammatory drugs.
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Affiliation(s)
- Chiara Caselli
- Institute of Clinical Physiology CNR, Via G. Moruzzi 1, Pisa, Italy.
| | | | - Rosetta Ragusa
- Institute of Clinical Physiology CNR, Via G. Moruzzi 1, Pisa, Italy.
| | - Valentina Lorenzoni
- Sant'Anna School of Advanced Studies, Piazza Martiri della Libertà, 33, Pisa, Italy.
| | - Jeff Smit
- Department of Cardiology, Heart Lung Center, Leiden University Medical Centre, Albinusdreef 2, RC, Leiden, the Netherlands.
| | - Mohammed El Mahdiui
- Department of Cardiology, Heart Lung Center, Leiden University Medical Centre, Albinusdreef 2, RC, Leiden, the Netherlands.
| | - Ronny R Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital and University of Zurich, Switzerland.
| | | | - Maria N Pizzi
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Albert Roque
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | - Juhani Knuuti
- PET Center, Turku University Hospital and University of Turku, Kiinamyllynkatu 4-8, Turku, Finland.
| | - Moritz Schütte
- Alacris Theranostics GmbH, Max-Planck-Straße 3, 12489 Berlin, Germany.
| | - Oberdan Parodi
- Fondazione Toscana G. Monasterio, Via G. Moruzzi 1, Pisa, Italy
| | - Gualtiero Pelosi
- Institute of Clinical Physiology CNR, Via G. Moruzzi 1, Pisa, Italy.
| | - Arthur Scholte
- Department of Cardiology, Heart Lung Center, Leiden University Medical Centre, Albinusdreef 2, RC, Leiden, the Netherlands.
| | | | - Danilo Neglia
- Fondazione Toscana G. Monasterio, Via G. Moruzzi 1, Pisa, Italy.
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