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Elevated circulating metalloproteinase 7 predicts recurrent cardiovascular events in patients with carotid stenosis: a prospective cohort study.
- Source :
-
BMC cardiovascular disorders [BMC Cardiovasc Disord] 2020 Feb 26; Vol. 20 (1), pp. 93. Date of Electronic Publication: 2020 Feb 26. - Publication Year :
- 2020
-
Abstract
- Background: Major adverse cardiovascular events are the main cause of morbidity and mortality over the long term in patients undergoing carotid endarterectomy. There are few reports assessing the prognostic value of markers of inflammation in relation to the risk of cardiovascular disease after carotid endarterectomy. Here, we aimed to determine whether matrix metalloproteinases (MMP-1, MMP-2, MMP-7, MMP-9 and MMP-10), tissue inhibitor of MMPs (TIMP-1) and in vivo inflammation studied by <superscript>18</superscript> F-FDG-PET/CT predict recurrent cardiovascular events in patients with carotid stenosis who underwent endarterectomy.<br />Methods: This prospective cohort study was carried out on 31 consecutive patients with symptomatic (23/31) or asymptomatic (8/31) severe (> 70%) carotid stenosis who were scheduled for carotid endarterectomy between July 2013 and March 2016. In addition, 26 healthy controls were included in the study. Plasma and serum samples were collected 2 days prior to surgery and tested for MMP-1, MMP-2, MMP-7, MMP-9, MMP-10, TIMP-1, high-density lipoprotein, low-density lipoprotein, high-sensitivity C-reactive protein and erythrocyte sedimentation rate. <superscript>18</superscript> F-FDG-PET/CT focusing on several territories' vascular wall metabolism was performed on 29 of the patients because of no presurgical availability in 2 symptomatic patients. Histological and immunohistochemical studies were performed with antibodies targeting MMP-10, MMP-9, TIMP-1 and CD68.<br />Results: The patients with carotid stenosis had significantly more circulating MMP-1, MMP-7 and MMP-10 than the healthy controls. Intraplaque TIMP-1 was correlated with its plasma level (r = 0.42 P = .02) and with <superscript>18</superscript> F-FDG uptake (r = 0.38 P = .05). We did not find any correlation between circulating MMPs and in vivo carotid plaque metabolism assessed by <superscript>18</superscript> F-FDG-PET. After a median follow-up of 1077 days, 4 cerebrovascular, 7 cardiovascular and 11 peripheral vascular events requiring hospitalization were registered. Circulating MMP-7 was capable of predicting events over and above the traditional risk factors (HR = 1.15 P = .006). When the model was associated with the variables of interest, the risk predicted by <superscript>18</superscript> F-FDG-PET was not significant.<br />Conclusions: Circulating MMP-7 may represent a novel marker for recurrent cardiovascular events in patients with moderate to severe carotid stenosis. MMP-7 may reflect the atherosclerotic burden but not plaque inflammation in this specific vascular territory.
- Subjects :
- Aged
Asymptomatic Diseases
Biomarkers blood
Cardiovascular Diseases diagnostic imaging
Carotid Stenosis complications
Carotid Stenosis diagnostic imaging
Carotid Stenosis surgery
Case-Control Studies
Endarterectomy, Carotid
Female
Humans
Longitudinal Studies
Male
Middle Aged
Positron Emission Tomography Computed Tomography
Prospective Studies
Recurrence
Risk Assessment
Risk Factors
Severity of Illness Index
Treatment Outcome
Up-Regulation
Cardiovascular Diseases etiology
Carotid Stenosis blood
Inflammation Mediators blood
Matrix Metalloproteinase 7 blood
Subjects
Details
- Language :
- English
- ISSN :
- 1471-2261
- Volume :
- 20
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- BMC cardiovascular disorders
- Publication Type :
- Academic Journal
- Accession number :
- 32101136
- Full Text :
- https://doi.org/10.1186/s12872-020-01387-3