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Lorente L, Martín MM, Ramos L, Cáceres JJ, Solé-Violán J, Argueso M, Jiménez A, Borreguero-León JM, Orbe J, Rodríguez JA, Páramo JA. Serum tissue inhibitor of matrix metalloproteinase-1 levels are associated with mortality in patients with malignant middle cerebral artery infarction. BMC Neurol 2015; 15:111. [PMID: 26162891 PMCID: PMC4499187 DOI: 10.1186/s12883-015-0364-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 06/28/2015] [Indexed: 01/20/2023] Open
Abstract
Background In the last years, circulating matrix metalloproteinases (MMP)-9 levels have been associated with functional outcome in ischemic stroke patients. However the prognostic value of circulating levels of tissue inhibitor of matrix metalloproteinases (TIMP)-1 and MMP-10 in functional outcome of ischemic stroke patients has been scarcely studied. In addition, to our knowledge, serum MMP-9, MMP-10 and TIMP-1 levels in patients with malignant middle cerebral artery infarction (MMCAI) for mortality prediction have not been studied, and these were the objectives of this study. Methods This was a multicenter, observational and prospective study carried out in six Spanish Intensive Care Units. We included patients with severe MMCAI defined as Glasgow Coma Scale (GCS) lower than 9. We measured circulating levels of MMP-9, MMP-10, TIMP-1, in 50 patients with severe MMCAI at diagnosis and in 50 healthy subjects. Endpoint was 30-day mortality. Results Patients with severe MMCAI showed higher serum levels of MMP-9 (p = 0.001), MMP-10 (p < 0.001), and TIMP-1 (p = 0.02) than healthy subjects. Non-surviving MMCAI patients (n = 26) compared to survivor ones (n = 24) showed higher circulating levels of TIMP-1 (p < 0.001), MMP-10 (p = 0.02) and PAI-1(p = 0.02), and lower MMP-9 levels (p = 0.04). Multiple binomial logistic regression analysis showed that serum TIMP-1 levels > 239 ng/mL are associated with 30-day mortality (OR = 5.82; 95 % CI = 1.37-24.73; P = 0.02) controlling for GCS and age. The area under the curve for TIMP-1 as predictor of 30-day mortality was 0.81 (95 % CI = 0.67-0.91; P < 0.001). We found an association between circulating levels of TIMP-1 and MMP-10 (rho = 0.45; P = 0.001), plasminogen activator inhibitor (PAI)-1 (rho = 0.53; P < 0.001), and tumor necrosis factor (TNF)-alpha (rho = 0.70; P < 0.001). Conclusions The most relevant and new findings of our study, were that serum TIMP-1 levels in MMCAI patients were associated with mortality, and could be used as a prognostic biomarker of mortality in MMCAI patients.
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Affiliation(s)
- Leonardo Lorente
- Intensive Care Unit, Hospital Universitario de Canarias, Ofra, s/n. La Laguna, 38320, Santa Cruz de Tenerife, Spain.
| | - María M Martín
- Intensive Care Unit, Hospital Universitario Nuestra Señora de Candelaria, Crta del Rosario s/n, Santa Cruz de Tenerife, 38010, Spain.
| | - Luis Ramos
- Intensive Care Unit, Hospital General La Palma, Buenavista de Arriba s/n, Breña Alta, La Palma, 38713, Spain.
| | - Juan J Cáceres
- Intensive Care Unit, Hospital Insular, Plaza Dr. Pasteur s/n, Las Palmas de Gran Canaria, 35016, Spain.
| | - Jordi Solé-Violán
- Intensive Care Unit, Hospital Universitario Dr. Negrín, Barranco de la Ballena s/n, Las Palmas de Gran Canaria, 35010, Spain.
| | - Mónica Argueso
- Intensive Care Unit, Hospital Clínico Universitario de Valencia, Avda. Blasco Ibáñez n°17-19, Valencia, 46004, Spain.
| | - Alejandro Jiménez
- Research Unit, Hospital Universitario de Canarias, Ofra, s/n. La Laguna, 38320, Santa Cruz de Tenerife, Spain.
| | - Juan M Borreguero-León
- Laboratory Deparment, Hospital Universitario de Canarias, Ofra, s/n. La Laguna, 38320, Santa Cruz de Tenerife, Spain.
| | - Josune Orbe
- Atherosclerosis Research Laboratory, CIMA-University of Navarra, Avda Pío XII n°55, Pamplona, 31008, Spain.
| | - José A Rodríguez
- Atherosclerosis Research Laboratory, CIMA-University of Navarra, Avda Pío XII n°55, Pamplona, 31008, Spain.
| | - José A Páramo
- Atherosclerosis Research Laboratory, CIMA-University of Navarra, Avda Pío XII n°55, Pamplona, 31008, Spain.
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Intimomedial thickness of the vertebral arteries complex: A new useful parameter for the assessment of atheroclerotic process? VOJNOSANIT PREGL 2011; 68:733-8. [DOI: 10.2298/vsp1109733j] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Bacground/Aim. An integral part of Doppler ultrasound examination of cervical
blood vessels is determination of intimomedial thicknes (IMT) of the common
carotid. The aim of the study was to estimate the relations between IMT of
the common carotid and vertebral arteries in order to determine if the value
of IMT obtained on the vertebral artery could be applied in clinical
practice. Methods. We measured IMT in a randomized, prospective and
crosssectional study, performed on 50 persons both sexes (29 men and 21
women), at the age from 18 to 79 years (mean age 52.4 ? 17.63 years). All the
persons were healthy, what was confirmed with clinical examination and
laboratory analyses. Measurements were perfomed from January 2006 until
September 2008. Intimomedial thickness was recorded by twodimensional
ultrasonography in B-mode on both common carotid arteries: one value was
obtained as average of three successeful measurements (measurements were
perform on different places). We measured IMT on the first segment of both
vertebral arteries, 1.5 cm proximal from the connection of the first and
second segments (we got results of the measurement of IMT on the vertebral
arteries in the same way: mean value from the three records). Results. (IMT =
0.782 ? 0.248 mm), obtained from 50 healthy persons, was higher than that
measured on the vertabral artery on the first segment (IMT = 0.585 ? 0.134
mm). The values of IMT after measurement on two different places were
statistically highly different (t = 7.03, SD = 0.028, p < 0.01). Coefficient
of variability of IMT values in carotid circulation (CV = 34.4%) was higher
than that in vertebral circulation (22.9%). Values of IMT on vertebral
arteries were in statistically significant correlation with those in carotid
circulation (r = 0.24 and t- = 2.48; p < 0.02). There were no statistically
significant difference between IMT measurement on the right and the left side
so they were analysed as the same set Conclusion. Values of IMT on the
vertebral arteries are one more undependent parameter of doplersonographic
examination of cervical vessels, which significantly correlates with IMT
values on common carotid artery. Variability of this parameter is lower, and
absolute values lower than the same in the common carotid artery. Therefore,
this parameter is probably not so sensitive. On the other hand, lower
variability of IMT values on the vertebral artery might be of higher
specificity for prediction of atherosclerotic progress by the increased
values of this parameter than based on IMT values obtained on the common
carotid arteries.
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