Long Term Prognostic Utility of Matrix Metalloproteinase-9 in Patients with Acute Coronary Syndrome - A Systematic Review

Background: Acute Coronary Syndrome (ACS) is the leading cause of morbidity and mortality in developed countries. Numerous groups have explored single and multiple biomarker strategies to identify diagnostic prognosticators of ACS, which will improve our ability to identify high-risk individuals. Matrix Metalloproteinase (MMP-9) is one potential biomarker, which has been widely studied in ACS. Recent reports have showed the prognostic utility of MMP-9, but due to inconsistent results, it has not been possible to draw firm conclusions. Objective: This review aims to explore the ability of MMP-9 to predict the long-term prognosis of ACS. To clarify this issue, we conducted a literature review to provide a comprehensive assessment of MMP-9 levels in ACS patients. Methods: We retrieved a total of 1501 articles from PubMed and Google Scholar. After thorough scrutiny, 12 original research articles were found fulfilling the inclusion-exclusion criteria. MMP-9’s ability as a biomarker of prognostication post ACS was reviewed. PRISMA guidelines were used for reporting. Results: The results revealed that MMP-9, apart from being an efficient diagnostic biomarker for ACS, helps in predicting the future risk of ACS with disease outcome. A positive correlation was found between plasma MMP-9 and left ventricular remodeling. A positive association was also found between cardiovascular death and higher MMP-9 levels. Conclusion: MMP-9 can be a potential prognostic marker for ACS and aids in identifying high-risk patients for intensive management during follow -up.