China National Clinical Research Center for Neurological Disease, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
National Health Commission Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases, Department of Pathology and Key Laboratory for Xinjiang Endemic and Ethnic Diseases, Shihezi University School of Medicine, Shihezi, Xinjiang, China.
Eur J Neurol. 2022 Oct;29(10):2976-2986. doi: 10.1111/ene.15342. Epub 2022 Apr 11.
To explore the relationship between baseline levels of matrix metalloproteinase 9 (MMP9) in peripheral blood and the outcomes in patients with acute minor stroke and transient ischemic attack (TIA).
We assessed data from patients with acute minor ischemic stroke or TIA who were included in the CHANCE (Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events) trial. Baseline level of MMP9 in peripheral blood is classified into five quintiles. We assessed the relationship between the baseline MMP9 and outcomes of stroke recurrence, composite vascular events, and poor functional outcomes within 90 days after stroke onset.
Of the 3014 patients included, 295 (9.79%) had recurrent stroke, 289 (9.59%) had recurrent ischemic stroke, 297 (9.85%) had combined vascular events, and 199 (6.64%) had poor functional outcomes within 90 days. We used MMP9 concentrations near hazard ratio (HR) = 1 (Q3) in restricted cubic splines as the reference. The result showed that, compared to patients in the Q3 group, patients in the highest quintile (Q5 group) had an increased risk of poor functional outcomes at 90 days after adjusting the risk factors and confounders (p = 0.030), which may be associated with an increased risk of combined vascular events (p = 0.052). Using Cox regression models or logistic regression models with restricted cubic spline, we also observed that higher MMP9 ratios were associated with an increased risk of stroke recurrence, combined events, and poor functional outcomes at a range of concentrations.
For patients with acute minor stroke or TIA, higher baseline MMP9 level was associated with an increased risk of poor functional outcomes, which might be related to stroke recurrence and combined vascular events.
探讨急性小卒中或短暂性脑缺血发作（TIA）患者外周血基质金属蛋白酶 9（MMP9）基线水平与结局之间的关系。
我们评估了 CHANCE（氯吡格雷在伴有急性非致残性脑血管事件的高危患者中的应用）试验中纳入的急性小缺血性卒中或 TIA 患者的数据。外周血 MMP9 基线水平分为五五分位。我们评估了 MMP9 基线水平与卒中复发、复合血管事件和卒中发病后 90 天内不良功能结局之间的关系。
在 3014 例患者中，295 例（9.79%）发生了卒中复发，289 例（9.59%）发生了复发性缺血性卒中，297 例（9.85%）发生了复合血管事件，199 例（6.64%）发生了卒中发病后 90 天内的不良功能结局。我们使用受限立方样条法中 HR=1（Q3）附近的 MMP9 浓度作为参考。结果表明，与 Q3 组患者相比，在调整了危险因素和混杂因素后，Q5 组（最高五分位组）患者在 90 天时有不良功能结局的风险增加（p=0.030），这可能与复合血管事件的风险增加有关（p=0.052）。使用 Cox 回归模型或受限立方样条逻辑回归模型，我们还观察到，在一定浓度范围内，较高的 MMP9 比值与卒中复发、复合事件和不良功能结局的风险增加相关。
对于急性小卒中或 TIA 患者，较高的基线 MMP9 水平与不良功能结局的风险增加相关，这可能与卒中复发和复合血管事件有关。
