39Differential Prognostication of MMP Subtypes in EF <45 As Compared to EF >45 During Hospitalisation with Acute Heart Failure

BackgroundThe differences in concentrations of MMP and its natural inhibitor TIMP in patients with EF 45 during hospitalisation with acute heart failure have yet to be defined. The objectives of this study were to compare the prognostic value of biomarkers of remodelling and fibrosis between these populations. Herein we evaluated the potential difference of circulating MMP (2,3,9) and TIMP (1-4) levels in these two groups of patients hospitalised with AHFMethodsA prospective observational study of 400 patients hospitalised with symptomatic acute heart failure was performed. Plasma levels of NT-proBNP, MMP-2, MMP-3, MMP-9, along with inhibitors (TIMP-1 to 4) were measured at admission and at discharge. Patients were divided into two groups (EF 45) based on TTE and the prognostic ability of the remodelling biomarkers was assessed prospectively. The primary end point was composite of all cause mortality and HF related hospitalisation at one year.ResultsMean LVEF was 25.6 plus or minus 96 plus or minus 9.1% in group 1 (282 patients) and 63.3 plus or minus 73 plus or minus 7.3% in group 2 (97 patients). High admission NT-proBNP, MMP-2 and low MMP-9 levels were noted in patients with EF 45 (P < 0P