Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
OBSERVATIONAL
2005-02-28
2007-05-31
Brief Summary
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It is conceivable that these polymorphisms correlate with the clinical outcome of acute coronary syndromes, particularly with those without ST segment Elevation (NSTEACS).
Detailed Description
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Many inflammatory and coagulation indicators have been investigated, although the critical factors responsible for complications in NSTEACS remain elusive.
Matrix remodeling and consequent erosion or fissuration of the unstable plaque is supposed to be a key step of the development of acute coronary syndromes.
Neutral matrix metalloproteinases 1, 3 and 9 have been demonstrated to be actively produced in atherosclerotic tissue, compared to unaffected arteries. Mechanisms responsible for such increased expression might be related to inflammation, but also genetic regulation could account for an increased expression leading to a different clinical outcome of the syndrome.
Genetic polymorphisms are described for all three MMPs involved in ACS. MMP-1 insertion of a G in position creates an ets binding site that induces an eight times increase of the synthesis rate. For MMP-3 (stromelysin) polymorphism, a deletion of an A (adenosine) in position -1171 doubles the transcription activity and has been recently associated with acute myocardial infarction and progression of coronary stenosis. In MMP-9 a more complex polymorphism involves a microsatellite (AC) repeat in position -90 to -131. The mechanism leading to increased MMP-9 expression is probably related to the transition to Z-DNA within the microsatellite, which eases transcription. In vitro studies show that the longer the tandem repeats sequence, the higher the transcription.
No studies on metalloproteinase polymorphism in NSTEACS have been carried out, so far.
This study has been planned to assess if patients admitted to the hospital for NSTEACS could be associated to a different in hospital clinical outcome according to the genetic polymorphism of these proteases.
Conditions
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Study Design
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DEFINED_POPULATION
PROSPECTIVE
Eligibility Criteria
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Inclusion Criteria
Exclusion Criteria
18 Years
ALL
No
Sponsors
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University of Trieste
OTHER
Principal Investigators
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Nicola FIOTTI, MD
Role: PRINCIPAL_INVESTIGATOR
University of Trieste, ITALY
Carlo Giansante, MD
Role: STUDY_CHAIR
University of Trieste, ITALY
Locations
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Azienda per i Servizi Sanitari n.6 "FRIULI OCCIDENTALE"
Pordenone, Pordenone, Italy
Clinica Medica - University of Trieste
Trieste, Trieste, Italy
Countries
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References
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Fiotti N, Altamura N, Fisicaro M, Carraro N, Uxa L, Grassi G, Torelli L, Gobbato R, Guarnieri G, Baxter BT, Giansante C. MMP-9 microsatellite polymorphism and susceptibility to carotid arteries atherosclerosis. Arterioscler Thromb Vasc Biol. 2006 Jun;26(6):1330-6. doi: 10.1161/01.ATV.0000219233.31702.c9. Epub 2006 Mar 30.
Galis ZS, Sukhova GK, Lark MW, Libby P. Increased expression of matrix metalloproteinases and matrix degrading activity in vulnerable regions of human atherosclerotic plaques. J Clin Invest. 1994 Dec;94(6):2493-503. doi: 10.1172/JCI117619.
Pollanen PJ, Lehtimaki T, Mikkelsson J, Ilveskoski E, Kunnas T, Perola M, Penttila A, Mattila KM, Nikkari ST, Syrjakoski K, Karhunen PJ. Matrix metalloproteinase3 and 9 gene promoter polymorphisms: joint action of two loci as a risk factor for coronary artery complicated plaques. Atherosclerosis. 2005 May;180(1):73-8. doi: 10.1016/j.atherosclerosis.2004.10.041. Epub 2004 Dec 18.
Terashima M, Akita H, Kanazawa K, Inoue N, Yamada S, Ito K, Matsuda Y, Takai E, Iwai C, Kurogane H, Yoshida Y, Yokoyama M. Stromelysin promoter 5A/6A polymorphism is associated with acute myocardial infarction. Circulation. 1999 Jun 1;99(21):2717-9. doi: 10.1161/01.cir.99.21.2717.
Fiotti N, Moretti ME, Bussani R, Altamura N, Zamolo F, Gerloni R, Ukovich L, Ober E, Silvestri F, Grassi G, Adovasio R, Giansante C. Features of vulnerable plaques and clinical outcome of UA/NSTEMI: Relationship with matrix metalloproteinase functional polymorphisms. Atherosclerosis. 2011 Mar;215(1):153-9. doi: 10.1016/j.atherosclerosis.2010.12.010. Epub 2010 Dec 21.
Other Identifiers
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FT-05-CG-201040106
Identifier Type: -
Identifier Source: org_study_id