Background:

Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) are involved in cardiac remodeling through regulation of extracellular matrix and eventually development of heart failure. We explored their association with heart failure (HF)‐related hospital length of stay (LOS‐HF).

Methods:

We prospectively examined the association of baseline serum levels of MMP ‐1, ‐2, and ‐9 and TIMP‐1, ‐2, ‐3, and ‐4 with outcomes (death, cardiac transplantation, left ventricular assist device implantation, or HF hospitalization) and their length of stay in the hospital related to those in 147 stable outpatients with HF from January 2008 to July 2009. Levels of MMPs and TIMPs were measured by fluorokine MAP, human MMP, and TIMP kits.

Results:

Mean age of patients was 56.5 ± 12 years, 66.7% were male, 57.8% were white, and 36.7% were black. Mean left ventricular ejection fraction was 24.6% ± 11%. During a mean follow‐up of 23.4 ± 6.7 months, 49 patients (33%) experienced an outcome event; of these, 42 patients were hospitalized and had a mean LOS‐HF of 6.6 ± 17.3 days. MMP‐2, TIMP‐2, and TIMP‐4 positively correlated with length of stay during HF hospitalization (LOS‐HF; r = 0.193, P < 0.02; r = 0.235, P < 0.01; r = 0.225, P < 0.01, respectively). Also LOS‐HF correlated positively with creatinine and negatively with EF and the 6‐minute walk test but did not correlate with brain natriuretic peptide (BNP); see Table 1. In multivariate analysis among significantly correlated MMPs and TIMPs, TIMP‐2 and TIMP‐4 were significant predictors of HF‐LOS. Even after adjusting for EF, BNP level, creatinine level, 6‐minute walk test, TIMP‐4, and age, using linear regression modeling, TIMP‐2 was still an independent predictor of LOS‐HF.

TABLE 1 Correlates of Length of Stay in the Hospital During Heart Failure Hospitalization

Conclusions:

Serum levels of TIMP‐2 were significantly and independently associated with length of stay during HF hospitalization in this cohort of stable outpatients with primarily systolic HF.

Disclosures:

V. Bhalla ‐ none; V. V. Georgiopoulou ‐ none; A. P. Kalogeropoulos ‐ none; L. Fike ‐ none; G. Giamouzis‐ none; C. P. Norton ‐ none; S. R. Laskar ‐ none; A. L. Smith ‐ none; J. Butler ‐ none