CTLA4 and heart failure: Metalloproteases type-9 (MMP-9) expression, another biomarker of cardiac fibrosis and heart failure, was also reduced by FMD treatment in mice also treated with anti-OX40/anti-PD-L1 and anti-PD-1/anti-CTLA-4 group (FMD anti-OX40/PD-L1 417.36 ± 102.5 vs AL anti-X40/anti-PD-L1 737.39 ± 102.5 pg/mg of total protein; FMD anti-PD-1/anti-CTLA-4 521.1 ± 88,4 vs to AL anti-PD-1/anti-CTLA-4 816.2 ± 66.7; p < 0.001) (Fig. 4C).