Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China.
Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
Nutr Metab Cardiovasc Dis. 2021 Jan 4;31(1):209-215. doi: 10.1016/j.numecd.2020.08.029. Epub 2020 Sep 17.
Whether the prognostic value of matrix metalloproteinase-9 (MMP-9) is modified by patients' dyslipidemia status is unknown. The aim of present study was to evaluate the prognostic effect of MMP-9 among ischemic stroke patients stratified by dyslipidemia status.
MMP-9 levels were measured for 2977 acute ischemic stroke patients from 26 participating hospitals across China, and data of clinical outcomes within one year after ischemic stroke was collected. The primary outcome was a composite outcome of major disability and death at one year after stroke onset, and secondary outcomes were major disability, death, vascular events and recurrent stroke. The association between MMP-9 and primary outcome was appreciably modified by dyslipidemia status (P = 0.048). After multivariate adjustment, increased MMP-9 level was associated with increased risk of primary outcome at one year after ischemic stroke in the patients with dyslipidemia (odds ratio, 1.34; 95% confidence interval, 1.06-1.79), but not in those without dyslipidemia (odds ratio, 1.23; 95% confidence interval, 0.90-1.68). Increased MMP-9 was also significantly associated with major disability, death and vascular events in the patients with dyslipidemia but not in those without dyslipidemia (P for interaction < 0.05 for all).
Increased MMP-9 was associated with poor prognosis within one-year after stroke only in patients with dyslipidemia, suggesting that the prognostic value of MMP-9 be modified by dyslipidemia status of ischemic stroke patients. Further prospective study from other populations and randomized clinical trials are needed to verify our findings and clarify the potential mechanisms.
基质金属蛋白酶-9（MMP-9）的预后价值是否受患者血脂异常状态的影响尚不清楚。本研究旨在评估 MMP-9 在按血脂异常状态分层的缺血性脑卒中患者中的预后作用。
在中国 26 家参与医院的 2977 例急性缺血性脑卒中患者中测量了 MMP-9 水平，并收集了缺血性脑卒中后 1 年内的临床结局数据。主要结局是脑卒中发病后 1 年时主要残疾和死亡的复合结局，次要结局是主要残疾、死亡、血管事件和复发性脑卒中。MMP-9 与主要结局的相关性明显受血脂异常状态的影响（P=0.048）。在多变量调整后，血脂异常患者中升高的 MMP-9 水平与缺血性脑卒中后 1 年主要结局的风险增加相关（比值比，1.34；95%置信区间，1.06-1.79），但在血脂正常的患者中无此相关性（比值比，1.23；95%置信区间，0.90-1.68）。升高的 MMP-9 也与血脂异常患者的主要残疾、死亡和血管事件显著相关，但与血脂正常的患者无此相关性（P 交互<0.05 均）。
只有血脂异常的患者中升高的 MMP-9 与脑卒中后 1 年内的不良预后相关，这表明 MMP-9 的预后价值受缺血性脑卒中患者血脂异常状态的影响。需要来自其他人群的前瞻性研究和随机临床试验来验证我们的发现并阐明潜在的机制。
