Association of Matrix Metalloproteinase-9 Levels with Myocardial Infarction in Patients Below 45 Years: A Case-control Study

Background The incidence of myocardial infarction among young adults has been rising in India, where acute coronary events are more frequently linked to plaque rupture than to severe coronary artery narrowing. Matrix metalloproteinase-9, an enzyme responsible for extracellular matrix remodeling, is believed to contribute to plaque instability and rupture. Objectives To determine serum matrix metalloproteinase-9 concentrations in patients younger than 45 years presenting with myocardial infarction. Another goal was to examine their relationship with parameters of lipid profile and established cardiovascular risk factors. Methods A hospital-based case-control study was carried out involving 50 patients aged 18-45 years with a first episode of myocardial infarction and 50 healthy individuals matched for age and sex. Serum matrix metalloproteinase-9 levels were quantified using a sandwich enzyme-linked immunosorbent assay technique. Lipid parameters were measured on an automated biochemical analyzer, and statistical evaluation was performed using Statistical Package for the Social Sciences version 20.0. Results Serum matrix metalloproteinase-9 concentrations were significantly higher in patients with myocardial infarction than in healthy controls ( P < .05). Low-density lipoprotein cholesterol levels were also significantly increased in the patient group. Receiver operating characteristic curve analysis indicated that serum matrix metalloproteinase-9 demonstrated a good ability to discriminate young myocardial infarction patients from healthy controls. Conclusion Higher circulating matrix metalloproteinase-9 levels showed a significant association with myocardial infarction in individuals younger than 45 years. These findings suggest that matrix metalloproteinase-9 may be a promising biomarker for identifying plaque instability at an early stage and may aid in cardiovascular risk assessment among young adults.