Matrix metalloproteinases (MMPs), which are important regulators of extracellular matrix degradation, are known to induce atherosclerotic plaque rupture because of the degradation of collagen fibers in the fibrous cap. We aimed to investigate the possible association between these enzymes and objective coronary angiographic parameters of epicardial or myocardial perfusion.A total of 140 patients with acute coronary syndromes or stable angina pectoris, who were advised to undergo coronary angiography, were included. The correlation between the serum levels of MMP-1, MMP-9, tissue inhibitor of matrix metalloproteinase-1, interleukin-6 (IL-6), and Thrombolysis in Myocardial Infarction frame count (TFC), myocardial blush grade, and the magnitude of change in these parameters after percutaneous intervention was investigated in addition to the association between MMPs and the need for revascularization.TFC and corrected TFC scores were found to be higher in patients with higher MMP-1 levels (R: 0.706, P < 0.001; R: 0.867, P < 0.001). The absolute amount of decrease in TFC/corrected TFC after percutaneous intervention in the patients, who were advised to undergo revascularization, was correlated with higher MMP-1 and MMP-9 levels. MMP-1, MMP-9, and IL-6 were negatively correlated with myocardial blush grade although this association was weaker for MMP-9 and IL-6 compared with MMP-1 (R: -0.574, -0.367, and -0.496, P < 0.001). The mean serum levels of MMP-1, MMP-9, and IL-6 were higher in the patients who were advised to undergo revascularization compared with the patients who did not need revascularization. Odds ratios of MMP-1 and IL-6 for predicting revascularization need were calculated as 1.7 (95% confidence interval: 1.4-2.1; P < 0.001) and 6.5 (95% confidence interval: 2.5-16; P < 0.001), respectively.Higher levels of serum MMP-1, MMP-9, and IL-6 can be used to predict worse coronary angiographic findings and may be further targets of active investigation for wide use as risk predictors.