Alterations of plasminogen activator inhibitor-1, myeloperoxidase and matrix metalloproteinase-9 in coronary artery disease patients with type-2 diabetes mellitus
Peteris Tretjakovs1,3, Antra Jurka1,2, Inga Bormane1, Guntis Bahs1,3, Kristine Cirule3, Agris Martinsons1, Jurijs Verbovenko1,3 & Valdis Pirags1,2
Aim: To evaluate alterations in plasminogen activator inhibitor-1 (PAI-1), myeloperoxidase (MPO) and matrix metalloproteinase-9 (MMP-9) levels, and their relation to insulin resistance (IR) in coronary artery disease (CAD) patients with stable and unstable angina with and without type-2 diabetes mellitus (T2DM).
Patients and methods: CAD patients were recruited into four groups: 16 CAD patients with stable angina and T2DM (SD); 16 CAD patients with stable angina, without T2DM (S); 16 CAD patients with unstable angina and T2DM (UD); and 16 CAD patients with unstable angina, without T2DM (U). 16 healthy subjects were selected as controls (C). The study groups were matched for age and sex. IR was measured by HOMA-IR method. Serum PAI-1 (total), MPO and MMP-9 were determined by xMAP technology (Luminex-200 analyzer).
Results: All patient groups demonstrated a significant increase in PAI-1, MPO and MMP-9 levels (P<0.05) and IR (P<0.05). The increase of PAI-1, MPO and MMP-9 was more pronounced in UD and U groups compared to SD and S groups (P<0.05), but the IR elevation was more pronounced in both diabetics groups (UD and SD). Only the concentration of PAI-1 and MMP-9 correlated with IR (P<0.05).
Conclusion: Our findings show that CAD patients independently of 2TDM have elevated IR, besides CAD patients with unstable angina have higher levels of PAI-1, MPO and MMP-9 than patients with stable angina.