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  1. Fulltext Smoking and Unstable Plaque in Acute Coronary Syndrome: A Systematic Review of The Role of Matrix Metalloproteinases
    Aminuddin A, Cheong SS, Roos NAC, Ugusman A
    Int J Med Sci, 2023;20(4):482-492.
    PMID: 37057211 DOI: 10.7150/ijms.79889
    Smoking is a risk factor of acute coronary syndrome (ACS) that could increase matrix metalloproteinases (MMPs) levels, leading to unstable coronary artery plaque. The current review aimed to identify the relationship between smoking and MMPs in patients with ACS. Literature search was conducted from inception until March 2022 in three online databases. Risk of bias was assessed using the Newcastle-Ottawa Scale. A meta-analysis was performed, and the odds ratio (OR) together with its 95% confidence interval (CI) were determined. A total of 7,843 articles were identified, and only seven studies were included. Four studies investigated the MMP-3 and MMP-9 related genes and found that smokers with certain MMPs genotypes had high risk of ACS. Smoking also increased the MMPs level in patients with ACS compared with non-smokers. Additionally, a meta-analysis of two studies resulted in an increased odd of ACS in smokers with MMP-3 5A allele versus non-smokers with MMP-3 6A6A allele (OR: 15.94, 95% CI: 10.63-23.92; I2 =55%). In conclusion, the current review highlights the role of MMPs in relation to smoking and ACS. The determination of these roles may help in identifying new ACS markers among smokers and the development of drug-targeted treatment.
  2. Prognostic value of pulse wave velocity for cardiovascular disease risk stratification in diabetic patients: A systematic review and meta-analysis
    Cheong SS, Samah N, Che Roos NA, Ugusman A, Mohamad MSF, Beh BC, et al.
    J Diabetes Complications, 2024 Dec;38(12):108894.
    PMID: 39531755 DOI: 10.1016/j.jdiacomp.2024.108894
    AIM: Arterial stiffness, a significant cardiovascular risk marker, is particularly important in patients with diabetes mellitus (DM). Pulse wave velocity (PWV), a non-invasive measure of arterial stiffness, has emerged as an independent predictor of cardiovascular morbidity and mortality. However, its precise prognostic value in DM patients for cardiovascular risk stratification remains unclear. To address this, a systematic review was conducted.

    METHOD: A thorough search of Ovid and Scopus databases was performed for cohort studies on PWV measurements for cardiovascular risk stratification in DM patients. Nine studies were included, examining the relationship between PWV and cardiovascular events or composite endpoints in DM patients asymptomatic of cardiovascular diseases (CVD).

    RESULTS: The review revealed that optimal PWV cutoffs to predict composite cardiovascular events ranged from 10 to 12.16 m/s (aortic PWV) and 14 to 16.72 m/s (brachial-ankle PWV). In addition, meta-analysis yielded a HR of 1.15 (95 % CI 1.07-1.24, p 

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