Despite the great achievements of modern cardiology in the diagnosis of coronary heart disease and the development of evidence-based recommendations for the management of patients with such a disease, it is still associated with a high incidence of life-threatening complications. Patients with coronary heart disease who develop acute myocardial infarction have a high risk of acute heart failure and fatal heart rhythm disorders, which can lead to the death of patients. The purpose of the study was to determine the dynamics of matrix metalloproteinase-9 and tissue metalloproteinase-2 inhibitor in patients with STEMI in different types of reperfusion therapy. Material and methods. The results of the study are based on the data of the comprehensive examination of 305 patients with coronary heart disease: 162 patients with STEMI, 81 persons with NSTEMI and 62 patients with angina pectoris (II and III functional class of 31 people) (the control group). All 305 examined patients were comparable in age, social status and sex (the ratio of men to women was 4 to 1). Results and discussion. The level of MPP-9 in the group of patients with STEMI was 5286.90 [4038.10-6116.80] PG / ml and was significantly higher than in the group of patients with NSTEMI (p < 0.05) –1858.90 [1493.30 - 2304.15] PG/ml, and in comparison with the group of stable coronary artery disease, where this figure was 466.70 [358.60-568.40] PG/ml, (p < 0.05). The dynamics of MPP-9 in patients with STEMI were grouped into subgroups depending on treatment strategy. In the subgroup of thrombolitic therapy with stenting after 2 weeks, the reduction of this indicator was valid and amounted to 1Δ % = -73,18 %; in the subgroup of thrombolytic therapy decline was less pronounced and amounted to 2Δ % = -44,87 % in the stenting subgroup. The reduction was significant at 3Δ % = -80,88 %, the decline was least in the subgroup of conservative therapy and was 4Δ % = -11,07 %, (p < 0.05). Conclusion. Among patients with STEMI, there was a significant increase in the level of MPP-9, TIMP-2 and the ratio of MPP-9 / TIMP-2, which allowed us to distinguish this category of patients from patients with unstable angina. The most pronounced decrease in the ratio of MPP-9 / TIMP-2 was among patients with STEMI in the subgroup of thrombolytic therapy with stenting at -93.04 % and the subgroup of stenting at -95.58 %. Further study of the dynamics of the matrix metalloproteinases system and their inhibitors through the state of recovery, will provide an opportunity to develop optimal management of patients with STEMI, improve the prognosis, and reduce the recurrence of cardiovascular events, which requires further research.

Keywords: coronary heart disease, matrix metalloproteinase-9, tissue inhibitor of matrix metalloproteinase-2, acute myocardial infarction

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