Original communicationMetalloproteinases and their inhibitors are markers of plaque instability
Section snippets
Materials and methods
Between January 2003 and December 2003, 53 consecutive patients (32 men, 21 women; mean age, 73 ± 7 years; median, 73 years; range, 60-87 years) presenting at our institution with internal carotid artery stenosis greater than 70% and no other vascular diseases (ie, abdominal aortic aneurysm and peripheral vascular disease) were entered into this study after informed consent was obtained. To exclude the concomitant presence of peripheral vascular and/or aneurysmal diseases, we screened patients
Results
Twenty-four (45%) carotid plaques were defined echographically as stable and 29 (55%) unstable with correct histologic confirmation on all carotid specimens. Twenty-five (86%) patients affected with unstable plaques were symptomatic, whereas 6 (25%) with stable plaques were symptomatic (P < .001). Table II shows the demographics, risk factors, associated diseases, and presenting symptoms of our population.
Discussion
The atherosclerotic plaque is a dynamic structure that undergoes continuous remodeling of the extracellular matrix on which its structural integrity depends. High levels of MMPs were demonstrated at the site of the inflammatory infiltrate in the fibrous cap leading to plaque instability.19 Elevated expression of several MMP species (MMP-1, -3, -12, and -13)4, 20 were observed within plaques. Brown et al10 and Henney et al12 identified members of the metalloproteinase family of enzymes in human
Conclusion
Our study demonstrated that an imbalance exists between MMPs and their inhibitors in unstable carotid plaque that may contribute to plaque instability and be a prelude to the onset of cerebral ischemic events. This imbalance could be monitored with plasma tests. Plasma levels of MMPs and TIMPs may represent valid markers of plaque instability and atherosclerosis-related inflammation, thus identifying a cohort of patients who warrant urgent intervention because of the risk for cerebral events
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2019, Neuroscience LettersCitation Excerpt :In previous study, we found the susceptibility to stroke was associated with increased MMP-9, and there was a positive association between MMP-9 and cold exposure–induced stroke incidence, this triggering effect might be mediated via the production of MMP-9 [5]. Previous studies have revealed that higher circulating MMP-9 levels were significantly correlated with cardiovascular risk [6], hemorrhagic transformation in stroke patients treated with t-PA [7], as well as a predictor for atherosclerotic plaque instability [8]. Biomarkers may potentially be as a useful tool for accurate evaluation of patients in relation to prognosis and monitoring.
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