The levels of matrix metalloproteinase-2, -9 and soluble ligand CD 40 in patients with coronary heart disease and susceptibility to psychological distress

Abstract

Objective. To examine the levels of matrix metalloproteinase (ММР)-2, -9 and soluble CD40 ligand (sCD40L) in patients with coronary artery disease with and without personality type D.

Materials and methods. We examined 744 patients with coronary heart disease at the age of 57.5 (51; 63) years prior to bypass surgery for the period from September 1, 2010 to March 1, 2011. From this cohort the concentrations of non-specific markers of subclinical inflammation: MMP-2, -9 and sCD40L were determined in 131 patients. For further study two groups were revealed: Group I (n =44) – patients with the presence of type D and Group II (n=87) – patients with no type D. Determining the type of personality was carried out using DS-14 questionnaire. Standard preoperative laboratory and instrumental studies were performed for all patients. Serum levels of MMP-2, -9 and sCD40L were determined by quantitative solid phase enzyme immunoassay.
Results. Data of almost all indicators were comparable between the two groups. MMP-2 concentration was significantly higher in the group with type D (195 ng/ml vs 169 ng/ml, p=0.037). In the group with no type D the higher concentrations of MMP-9 (62.5 ng/ml vs 49.3 ng/ml, p=0.028) and sCD40L (6,25 ng/ml versus 4.45 ng/ml, p=0.006) were revealed. Parameters of lipids were higher in the group with no type D. According to the results of multivariate analysis independent predictors for MMP-2 increase had been smoking (OR 2.92; 95% CI 1.11–7.73; p=0.028) and type D personality presence (OR 3.45; 95% CI 1.39–8.57; p=0.007); for sCD40L – type 2 diabetes presence (OR 4.95; 95% CI 1.25–19.61; p=0.021). The high level of MMP-9 was associated with stroke history presence (RR 6.02; 95% CI 1.25–29.03; p=0.024), and in the lesser degree – with unstable angina presence (RR 3.47; 95% CI, 0.57–21.02; p=0.17).
Conclusion. The presence of personality type D contributed to higher MMP-2 levels. The patients without type D had higher levels of lipids and increased levels of MMP-9 and sCD40L.