The role of matrix metalloproteinases in acute coronary syndromes

Matrix metalloproteinases (MMPs) are an expanding group of proteolytic enzymes that participate in numerous physiological and pathological processes including embryogenesis, connective tissue turn-over, healing, angiogenesis, etc. Disturbances in matrixin activity are observed in carcinogenesis, some degenerative processes, and in inflammation, including atherogenesis. The role of matrixins in the pathology of the cardiovascular system seems to be particularly important in two processes: (1) atherosclerotic plaque development and rupture (leading to an acute coronary event) and (2) post-infarction remodeling of myocardium, leading to heart failure. The purpose of this paper is to gather and summarize information about the role of MMPs in acute coronary syndromes (ACS), in both the processes leading to coronary artery occlusion and the “myocardial consequence” of this event. In addition, some benefits and disadvantages of pharmacological intervention into this enzymatic network will be addressed.