title: MMP-9 levels in elderly patients with cognitive dysfunction after carotid surgery.
abstract: Approximately 25% of elderly patients scheduled for carotid endarterectomy (CEA) develop post-operative cognitive dysfunction (CD). We tested the hypothesis that the plasma levels of matrix metalloproteinase 9 (MMP-9) are predictive of moderate to severe CD after CEA. A total of 73 patients were prospectively enrolled in this Institutional Review Board-approved study. Plasma samples were obtained at baseline and day 1 post-surgery. We measured the plasma concentrations of both MMP-9 and its inhibitor, tissue inhibitor of metalloproteinases 1 (TIMP-1). We estimated the MMP-9 activity by calculating the MMP-9:TIMP-1 ratio. The cognitive performance day 1 post-surgery was quantified with z-scores, using a control group who were undergoing spinal surgery. The criteria used to define CD was performance of >or=1.5 standard deviations worse than the control group; approximately 19% of eligible patients developed CD. Compared to patients without CD, this group had both higher total (81.66+/-12.25 ng/mL versus [vs.] 43.18+/-4.44 ng/mL, p=0.005) and activity (0.88+/-0.24 ng/mL vs. 0.54+/-0.06 ng/mL, p=0.003) MMP-9 levels at baseline. All of the results were adjusted for age, diabetes and neurovascular symptoms.
authors.affiliation: Department of Anesthesiology, New York Presbyterian Hospital, Columbia University, 620 West 168th Street, New York, New York 10032, USA.
authors.forename: John G
authors.initials: JG
authors.lastname: Gaudet
authors.forename: Gene T
authors.initials: GT
authors.lastname: Yocum
authors.forename: Susie S
authors.initials: SS
authors.lastname: Lee
authors.forename: Anna
authors.initials: A
authors.lastname: Granat
authors.forename: Maya
authors.initials: M
authors.lastname: Mikami
authors.forename: E Sander
authors.initials: ES
authors.lastname: Connolly
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Heyer
mesh_terms: D000368:Aged; D003072:Cognition Disorders / Q000201:enzymology* / Q000209:etiology; D016894:Endarterectomy, Carotid / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood*; D008875:Middle Aged; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000201:enzymology* / Q000209:etiology; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000097:blood
chemical_list: D019715:Tissue Inhibitor of Metalloproteinase-1; D020780:Matrix Metalloproteinase 9