Prognostic value of serial measurements of matrix metalloproteinase-9 in stage III essential hypertension patients
The aim - to investigate the predictive value of serial measurements of circulating matrix metalloproteinase-9 level in stage III essential hypertension patients at 12 months after ischemic stroke. Material and methods. 102 patients with mild to moderate essential hypertension within 3 weeks after ischemic stroke were included into the study. Neurological impairment at presentation was assessed by National Institute of Health Stroke Scale (NIHSS). The type of acute ischemic stroke was classified according to the TOAST classification. The Barthel Index and the modified Rankin Scale were used to assess functional disability. The functional outcome was evaluated at admission and on the 21st day of stroke before including into the study. Contrast-enhanced computer spiral tomography (CT) was performed. Follow-up was 12 months with 3 month intervals. The circulating matrix metalloproteinase-9 (MMP-9) level was assessed at baseline and after six months of baseline. Results. One hundred two mild-to-moderate arterial hypertension patients (67 men and 35 women; mean age, 58.38 years (95 % CI 54-72 years)) were included in this study in 3 weeks after first clinical signs of ischemic stroke. NIHSS score of the series at admission and in 21st day after hospitalization date was 10 (interquartile range of 7-18) and 5 (interquartile range of 3-9) respectivelly. The median Barthel Index score was 65 (interquartile range of 40 to 85) at admission and 75 (interquartile range of 55 to 90) on the 21st day of hospitalization; and the median Rankin Scale score was 4 (interquartile range of 2 to 5) at admission and on the 21st day before enrollment, respectively. During observation period 58 cumulative clinical events occurred. Increased MMP-9 concentration within six months after ischemic stroke was positively associated with incidence of cardiovascular events, when compared with individuals without increased circulating levels of MMP-9. Conclusion. We found that circulating MMP-9 level is an independent predictor of 1 year cumulative cardiovascular events in patients with stage III hypertension after cerebral ischemic stroke.