Serum matrix metalloproteinase-9 levels and prognosis of acute ischemic stroke

作者：Chongke Zhong, Jingyuan Yang, Tan Xu, Tian Xu, Yanbo Peng, Aili Wang, Jinchao Wang, Hao Peng, Qunwei Li, Zhong Ju, Deqin Geng, Yonghong Zhang, Jiang He, For the CATIS Investigators, CATIS Investigators, Jiang He, Yonghong Zhang, Tan Xu, Dali Wang, Yanbo Peng, Jinchao Wang, Zhong Ju, Qunwei Li, Deqin Geng, Jintao Zhang, Li Dong, Fengshan Zhang, Libing Guo, Yingxian Sun, Xuemei Wang, Yong Cui, Yongqiu Li, Dihui Ma, Dongsheng Zhang, Guang Yang, Yanjun Gao, Liang Zhao, Xiaodong Yuan, Xiujie Han, Mingyu Zhang, Shurong Duan, Tao Feng, Jizhen Li, Suzhen Liu, Wei Hu, Chun Nie, Nuenjiya Zhao · 发表于：Neurology · 年份：2017 · DOI：10.1212/wnl.0000000000004257 · 被引用次数：167 · 研究领域：Protease and Inhibitor Mechanisms、Acute Ischemic Stroke Management、S100 Proteins and Annexins

Objective: To examine the association between serum matrix metalloproteinases-9 (MMP-9) levels and prognosis of acute ischemic stroke. Methods: We measured serum MMP-9 levels in 3,186 participants (2,008 men and 1,178 women) from the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS). Study outcome data on death, major disability (modified Rankin Scale score ≥3), and vascular disease were collected at 3 months after stroke onset. Results: During 3 months of follow-up, 767 participants (24.6%) experienced major disability or died. Serum MMP-9 was significantly associated with an increased risk of death and major disability after adjustment for age, sex, time from onset to randomization, current smoking, alcohol drinking, admission NIH Stroke Scale score, diastolic blood pressure, plasma glucose, white blood cell counts, use of antihypertensive medications, and history of hypertension, coronary heart disease, and diabetes mellitus. For example, 1-SD (0.32 ng/mL) higher log–MMP-9 was associated with an odds ratio (95% confidence interval) of 1.16 (1.06–1.28) for the combined outcome of death and major disability, 1.12 (1.01–1.23) for major disability, and 1.29 (1.01–1.66) for death. The addition of serum MMP-9 to conventional risk factors improved risk prediction of the combined outcome of death or major disability (net reclassification index 9.1%, p = 0.033; integrated discrimination improvement 0.4%, p = 0.004). Conclusions: Higher serum MMP-9 levels in t...