| Sažetak: | Background: Acute heart failure (AHF) after acute coronary syndrome (ACS) is the
biggest complication with a poor prognosis in a long term. The influence of MMP-9
as proteolytic enzyme that degrades extracellular matrix in remodeling left ventricle
was recognized. However, according to researcher�s knowledge, evaluation of the
MMP-9 as a predictor of AHF after ACS was never reported.
Objective: To find out the serum level of MMP-9 in ACS with AHF higher than that
without it, as well as to find out the level of MMP-9 with risk of AHF after ACS.
Method: The study used a cross-sectional study. Samples were collected by using a
consecutive sampling technique among patients with ACS treated in ICCU of Public
Hospital Dr Sardjito Yogyakarta, since June 2008 to August 2010. Questionnaires
were used to collect sample raw data. The level of MMP-9 was examined a time at
admission in ICCU before trombolysis was done. The heart failure had Killip II- IV
scores. Factors influencing the incidence was analyzed by using multivariate analysis
technique. A significance level was at p< 0.05. The relative risk of acute heart failure
at a certain level of MMP-9 (from cut-off value) was obtained after it was adjusted.
Result: Among 122 subjects, 75 was without AHF and 47 with AHF. Median of the
level of MMP-9 in the whole sample of ACS was 1248.55 ng/mL with a minimum of
170.50 ng/mL and maximum of 3058.40 ng/mL. Moreover, the level of MMP-9 in
ACS with AHF (1700.81±740.43 ng/mL) was significantly higher than ACS without
AHF (1189.55±654.60 ng/mL) with p value = 0.000. Independent risk factor after
the multivariate analysis was done indicates the level of MMP-9 above 1444 ng/mL
(RR= 4.2) and the location of anterior infarction (RR= 2.9).
Conclusion: In patients with ACS treated in ICCU of RSUP Dr Sardjito, the level
of MMP-9 with AHF was higher than that without it. If the level of MMP-9 above
1444 ng/mL, the possibility of AHF was 4.2 times.
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