MMP-9 levels in elderly patients with cognitive dysfunction after carotid surgery

Area of Science:

• Neurology
• Biochemistry
• Cardiovascular Surgery

Background:

• Post-operative cognitive dysfunction (CD) affects approximately 25% of elderly patients undergoing carotid endarterectomy (CEA).
• The underlying mechanisms of CD following CEA are not fully understood.
• Identifying predictive biomarkers for CD is crucial for patient management.

Purpose of the Study:

• To investigate whether plasma levels of matrix metalloproteinase 9 (MMP-9) can predict moderate to severe CD after CEA.
• To assess the relationship between MMP-9 activity and the development of CD.

Main Methods:

• Prospective study of 73 patients scheduled for CEA.
• Plasma MMP-9 and tissue inhibitor of metalloproteinases 1 (TIMP-1) concentrations measured at baseline and post-surgery.
• MMP-9 activity estimated using the MMP-9:TIMP-1 ratio.
• Cognitive performance assessed using z-scores compared to a spinal surgery control group.

Main Results:

• Approximately 19% of eligible patients developed CD.
• Patients with CD exhibited significantly higher baseline total MMP-9 levels (81.66 vs. 43.18 ng/mL, p=0.005).
• Elevated baseline MMP-9 activity (0.88 vs. 0.54, p=0.003) was also observed in patients who developed CD.
• Results were adjusted for age, diabetes, and neurovascular symptoms.

Conclusions:

• Baseline plasma MMP-9 levels and activity are significant predictors of moderate to severe cognitive dysfunction after CEA.
• MMP-9 may play a role in the pathophysiology of post-CEA CD.
• Further research into MMP-9 inhibition could offer therapeutic strategies for preventing CD.