Keywords
stenosing atherosclerosis of the carotid arteries
biomarkers of inflammation
C-reactive protein
matrix metalloproteinase 9
How to Cite
Abstract
In press
Background. Atherosclerosis is a chronic inflammatory disease of the vascular wall. The diagnostic role of Matrix MetalloProteinase 9 (MMP 9) in ischemic stroke in patients with carotid atherosclerosis is not sufficiently understood.
Aim. To investigate the level of MMP 9 in serum in patients with acute ischemic stroke and stenotic and non-stenotic atherosclerosis of the extracranial carotid arteries.
Materials and Methods. A total of 100 patients with ischemic stroke on the background of carotid atherosclerosis were examined and divided into 2 groups depending on the degree of stenosis: 50 patients with carotid stenosis >50% of the lumen and 50 patients with stenosis <50%. The control group included 20 clinically healthy individuals. Stroke severity was assessed, carotid ultrasound was performed, and levels of total cholesterol and its fractions, triglycerides, high‑sensitivity C‑reactive protein, and MMP‑9 in blood serum were measured by enzyme‑linked immunosorbent assay. Statistical analysis was performed using parametric and non‑parametric methods, with Statistica 8.0 (Statsoft, USA) at a critical p‑level of 0.05. The study was carried out as part of the second author’s dissertation research.
Research Ethics. The study was conducted in compliance with the principles of the World Medical Association Declaration of Helsinki (1964–2024), the Order of the Ministry of Health of Ukraine No.690 of September 23, 2009, and the opinion of the Bioethics Commission of the Kharkiv Medical Academy of Postgraduate Education No.1 of February 18, 2020. All patients provided signed informed consent.
Results. In the group with stenosing carotid atherosclerosis, median total cholesterol was 6.6% higher, low-density lipoprotein cholesterol was 13.6% higher, and high-density lipoprotein cholesterol was 10.8% lower compared with the non-stenosing group. The median high-sensitivity C-reactive protein in the group with stenosing atherosclerosis was 6.75 [4.25; 6.97] ng/mL versus 5.00 [4.93; 5.06] ng/mL in the non-stenosing group, reflecting a 35.1% higher level of systemic inflammation. The level of MMP 9 was statistically significantly increased in the examined patients compared to clinically healthy individuals ([51.49±17.69] ng/ml), and also significantly differed depending on the degree of stenosis: [116.31±20.93] ng/ml in stenotic, [92.64±21.42] ng/ml in non-stenotic atherosclerosis.
Conclusions. The presence of stenotic atherosclerosis of extracranial arteries was associated with more pronounced dyslipidemia and a higher level of laboratory inflammation. MMP-9 is an informative laboratory indicator that reflects the activity of the atherosclerotic process in ischemic stroke.
Keywords: neurology, stenosing atherosclerosis of the carotid arteries, biomarkers of inflammation, C-reactive protein, matrix metalloproteinase 9.
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