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Abstract Background and aims This study investigated risks of short-term (1 and 3 months) and long-term (1-year) recurrent stroke associated with glomerular filtration rate (eGFR) in patients with acute ischemic stroke. Methods From the Taiwan Stroke Registry data, we identified 45,876 acute ischemic stroke patients from April 2006 to April 2014 and classified them into 4 groups based on the eGFR at admission: ≥ 90, 60–89, 30–59, and <30 mL/min/1.73 m2 or on dialysis. The risks of 1-month, 3-month and 1-year recurrent stroke related to the eGFR levels were investigated. Results Both the risks of short-term and long-term recurrent stroke increased as the eGFR levels declined. The 1-month recurrent incidence rates increased steadily from 0.54 to 0.59, 0.84 and 0.89 per 1000 person-days, as the eGFR declined from ≥90 to 60–89, 30–59, and <30 mL/min/1.73 m2 or on dialysis, respectively. Compared to patients with eGFR ≥90 mL/min/1.73 m2, the adjusted subhazard ratio of 1-month recurrent stroke decreased from 1.69 (95% confidence interval (CI) = 1.24–2.31) for patients with eGFR < 30 mL/min/1.73 m2 or on dialysis to 1.14 (95% CI = 0.91–1.43) for patients with eGFRs of 60–89 mL/min/1.73 m2, considering the competing risk of deaths. Similar patterns were also observed for the adjusted HRs of 3-month and 1-year recurrent stroke, but with reduced hazard values, by the corresponding eGFR levels. Conclusions There is an independent graded association between an increased risk of recurrent stroke and declining eGFR levels in patients with acute ischemic stroke. Highlights • This study investigated the recurrent stroke risks in ischemic stroke patients by the glomerular filtration rate (eGFR). • The eGFR levels were classified to 4 categories: ≥90, 60–89, 30–59, and <30 mL/min/1.73 m2 or on dialysis. • There is an independent graded association between an increasing risk of recurrent stroke and the declining eGFR. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Matrix metalloproteinases (MMPs) are implicated in the pathogenesis of atherosclerosis. However, the relationship between blood levels of MMPs and the extent of carotid atherosclerosis remains uncertain. We assessed blood levels of active MMPs in relation to the extent of carotid plaque formation and intima–media thickness (IMT) in a community population in Taiwan. Methods: In 433 subjects from a community primary stroke prevention program, blood levels of active MMP-1, total and active MMP-3 and active MMP-9 were determined using enzyme-linked immunosorbent assays, carotid plaque score (PS) and IMT by high-resolution B-mode ultrasonography and the common MMP-1, MMP-3, and MMP-9 promoter low- and high-activity genotypes by polymerase chain reaction and restriction fragment length polymorphism. Results: Study subjects were separated into 3 groups based on PS: group 1 (PS=0), group 2 (PS=1–2) and group 3 (PS≥3). Blood levels of active and total MMP-3 bear a highly significant relationship with PS (both p <0.0001). A multiple ordinal logistic regression analysis revealed that blood levels of active MMP-3 are correlated with PS (OR, 1.4; 95% CI, 1.1–1.8; p =0.0038) but not IMT. MMP-3 −1612 6A6A is a dominant genotype in this population, which is associated with higher levels of blood active MMP-3. Conclusion: Blood levels of active MMP-3 are associated with the extent of carotid atherosclerosis based on PS but not IMT in this community population in Taiwan and the MMP-3 −1612 6A6A genotype is associated with higher levels of blood active MMP-3. [ABSTRACT FROM AUTHOR]