Background: Extracellular matrix remodeling is a component of coronary artery disease (CAD). Matrix metalloproteinases (MMPs) are enzymes involved in extracellular matrix degradation. The extrapolation of the role MMPs play in the clinical setting of acute coronary syndromes has not yet been defined. Methods: Samples from 100 subjects undergoing cardiac catheterization were analyzed for serum levels of MMP‐1, MMP‐2, and MMP‐9. These markers were assessed before, immediately after, and 24 hours after cardiac catheterization. Relationships among MMP levels, baseline characteristics, angiography findings and clinical course were assessed. Results: Comparing subjects with myocardial infarction versus those without, baseline MMP‐1 levels were not different at baseline but increased during the hospital stay, MMP‐2 levels were higher at baseline and throughout the monitoring period and MMP‐9 levels lower and decreased over time. MMP‐1 was higher 24 hours after catheterization in subjects undergoing revascularization. Subjects undergoing percutaneous revascularization had higher MMP‐9 levels following revascularization than those subjects undergoing angiography without angioplasty. Conclusions: Serial monitoring of MMPs indicates a differential subtype response to myocardial infarction and percutaneous revascularization. Results of this study indicate that MMP subtypes may play differing roles in the manifestation of acute coronary syndromes and response to revascularization. (J Interven Cardiol 2004;17:27–31)

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Cardiology teleconsultation provides a valuable service to deployed providers, decreases medical evacuation costs, and facilitates transfer of patients to appropriate facilities.