Objective To investigate the relationships of the expression of serum matrix metalloproteinase-9 (MMP-9), soluble urokinase type plasmin activator receptor (suPAR) and plasmin activator inhibitor-1 (PAI-1) with the cardiac function grading and prognosis in elderly patients with chronic heart failure (CHF).
Methods A total of 108 CHF patients and 50 healthy individuals with physical examination in the same period in Langfang City Hospital of Traditional Chinese Medicine were respectively selected as study group and control group. The blood samples were collected for detection of serum levels of MMP-9, suPAR and PAI-1. The differences in serum indicators among patients with different cardiac functional grades of the New York Heart Association (NYHA) and different prognoses were compared, and the predictive values of serum indicators for poor prognosis were analyzed as well.
Results Compared with the control group, the serum levels of MMP-9, suPAR and PAI-1 in the study group were significantly higher (P < 0.05). The levels of serum MMP-9, suPARand PAI-1 increased gradually and significantly in patients with the increase of NYHA grading as grade Ⅱ, grade Ⅲ and grade Ⅳ (P < 0.05). The results of the one-year follow-up showed that there were 65 cases with good prognosis and 43 cases with poor prognosis, and the poor prognosis rate was 39.81% (43/108). Compared with patients of good prognosis, patients with poor prognosis had higher age, higher incidence of complicated hypertension, lower left ventricular ejection fraction (LVEF), and higher levels of left ventricular end diastolic diameter (LVEDD), MMP-9, suPAR and PAI-1 (P < 0.05). Logistic regression analysis showed that age, MMP-9, suPAR and PAI-1 were the risk factors for poor prognosis in elderly patients with CHF, while LVEF was a protective factor for poor prognosis in elderly patients with CHF (P < 0.05). The area under the curve (AUC) of serum MMP-9, suPAR and PAI-1 detected separately and in combination were 0.711, 0.829, 0.768 and 0.840 respectively, the sensitivity and specificity of the three indexes in combination were 88.21% and 79.46% respectively.
Conclusion The expression levels of serum MMP-9, suPAR and PAI-1 in elderly patients with CHF are closely related to thecardiac functional grading and poor prognosis.
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