Kalashnyk D. Matrix metalloproteinase - 9 and other inflammation markers in ischemic heart disease in the dynamic of the treatment with statins.

Object of the study: Different forms of CAD (stable angina of effort, FC 2-3 and unstable progressing angina). Purpose of the study: To improve the efficacy of CAD treatment (stable and unstable angina) basing on the study of inflammation markers (CRP, TNF-?) and matrix metalloproteinase-9 at treatment with statins. Methods of the investigation: Clinical, instrumental, enzyme, immunoenzyme, photometry. Theoretical and practical results: Early detection of serum MMP-9, CRP and TNF-? for assessment of destabilized CAD course and statin therapy efficacy was substantiated. Two declaration patents of Ukraine were obtained according to the received findings. The obtained findings suggest that administration of simvastatin from the first days of CAD destabilization at a dose of 40 mg per day more effectively reduced MMP-9, MDA when compared with the dose of 20 mg per day. More marked influence of the dose of 40 mg on the parameters of the clinical course of the disease (the number of hospitalizations due toCAD destabilization, cardiovascular death) was established, which allows to recommend statin administration to all patients with CAD during a long period (not less than 12 months) to improve the disease prognosis. Novelty: The role of matrix metalloproteinase-9 and inflammation markers (SRP, TNF-?) both in patients with stable angina and at the course destabilization was further investigated in the work. Direct correlation between the level of MMP-9 and inflammation markers in patients with unstable angina was established. It was determined that considerable increase of atherogenic lipids could be one of the factors contributing elevation of the level of matrix metalloproteinases. The investigation with simvastatin at a dose of 20 and 40 mg per day in patients with unstable angina established the advantages of the dose of 40 mg not only in the influence on the lipid level but also serum MMP-9, MDA levels. The obtained findings expanded the available information about early development of pleiotropic effectsof statins such as anti-inflammatory and endothelium-protective, which develop 14 days after therapy with simvastatin. Anti-ischemic efficacy of simvastatin was demonstrated by the findings of tred-mill test after a month of therapy, which was due to pleotrophic effects of simvastatin. Degree of introduction: The findings of the research were introduced into the work of infarction department of Institute of Therapy named after L.T. Malaya (AMS of Ukraine), cardiology departments of regional clinical hospitals of Dneptopetrovsk, Nikolayev, Kirovograd, Chernigov. Sphere of application: Medicine, cardiology.