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Background: Sirtuin 1 (SIRT1) appears to play a protective role against endothelial dysfunction and oxidative stress. Instead, matrix metalloproteinase 2 (MMP2) is involved in acute coronary events, by promoting tissue remodeling. This study sought to determine the clinical value of a prognostic index arising from the combination of these two biomarkers for myocardial infarction (MI) in patients with advanced coronary artery disease., Methods: Eighty-one patients with advanced coronary artery disease planned for open heart surgery were prospectively enrolled. Serum levels of SIRT1 and MMP2 were measured by ELISA. To look at the relation of these mediators with clinical characteristics, pre-operative data and patients demographics were collected., Results: SIRT1 levels correlated marginally with a history of hypertension (ρ=0.2, p=0.084) and inversely with baseline urea (ρ=0.25, p=0.056). When performing additional adjustment, low SIRT1 levels were independently associated with diabetes mellitus 2(DM2) and subjects with SIRT1 <2.95ng/mL were more prone to present DM2 (82% sensitivity and 62% specificity). The index of low SIRT1 and high MMP2 respectively correlated with patients history of MI (ρ=0.3, p=0.01) and marginally with presence or history of atrial fibrillation (AF) (ρ=0.213, p=0.076). When adjusting for anthropometric and comorbidities, the combined index tended to have an association with impaired ejection fraction (EF)<55% (p=0.059)., Conclusions: The combined index of low SIRT1 and high MMP2 exhibited a significant correlation with history of MI and EF, promoting a potential prognostic tool for MI incidence in patients regardless their coronary artery disease status., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Background: OCT with its unique image resolution is the ideal method to detect culprit lesion characteristics in different clinical presentations. The identification of inflammatory markers related to plaque characteristics may be of clinical importance., Methods: Thirty-two patients with acute coronary syndromes (ACS) and fourteen patients with stable angina pectoris (SAP) were enrolled in this study. Culprit lesion morphology was assessed by optical coherence tomography (OCT) in patients with ACS and SAP. The possible relations between serum levels of high sensitivity-C reactive protein (hs-CRP) and interleukin-18 (IL-18) with plaque characteristics were investigated in those patients., Results: Plaque rupture and thin-cap fibroatheroma (TCFA) were detected more frequently in ACS patients compared with SAP patients, (78.6% vs. 14.3%, p<0.001, 92.9% vs. 14.3%, p<0.001, respectively). Higher levels of serum hs-CRP and IL-18 were found in patients with plaque rupture vs. those with no plaque rupture (median value: 19.2mg/L vs. 1.6 mg/L, p<0.001 and 219.5 pg/ml vs. 127.5 pg/ml, p=0.001 respectively), and TCFA vs. those without TCFA (median value: 15.2mg/L vs. 1.6 mg/L, p=0.004 and 209.0 pg/ml vs.153.2 pg/ml, p=0.03 respectively). Serum hs-CRP was the only independent predictor of plaque rupture (p=0.02, odds ratio 1.1, 95% confidence interval 1.0 to 1.2). A cut-off value of hs-CRP>4.5mg/L could detect ruptured plaque with a sensitivity of 91.7% and a specificity of 77.8%., Conclusions: OCT detected plaque rupture and TCFA more frequent in ACS patients compared with SAP. Elevated hs-CRP and IL-18 were positively related to plaque instability and rupture., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)