Serum Matrix Metalloproteinase-9 Is Associated With Depression After Acute Ischemic Stroke

Bizhong Che; Chongke Zhong; Jinzhuo Ge; Ruyi Li; Zhengbao Zhu; Xiaoqing Bu; Tan Xu; Zhong Ju; Jiale Liu; Jintao Zhang; Jing Chen; Yonghong Zhang; Jiang He

doi:10.1253/circj.CJ-19-0376

Stroke

Serum Matrix Metalloproteinase-9 Is Associated With Depression After Acute Ischemic Stroke

Bizhong Che, Chongke Zhong, Jinzhuo Ge, Ruyi Li, Zhengbao Zhu, Xiaoqing Bu, Tan Xu, Zhong Ju, Jiale Liu, Jintao Zhang, Jing Chen, Yonghong Zhang, Jiang He

Author information

Bizhong Che
School of Public Health, Medical College of Soochow University [China]
Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University [China]
Chongke Zhong
School of Public Health, Medical College of Soochow University [China]
Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University [China]
Jinzhuo Ge
School of Public Health, Medical College of Soochow University [China]
Ruyi Li
School of Public Health, Medical College of Soochow University [China]
Zhengbao Zhu
School of Public Health, Medical College of Soochow University [China]
Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University [China]
Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine [United States]
Xiaoqing Bu
School of Public Health, Medical College of Soochow University [China]
Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University [China]
Department of Epidemiology, School of Public Health, Chongqing Medical University [China]
Tan Xu
School of Public Health, Medical College of Soochow University [China]
Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University [China]
Zhong Ju
Department of Neurology, Kerqin District First People’s Hospital of Tongliao City [China]
Jiale Liu
Department of Neurology, Jilin Central Hospital [China]
Jintao Zhang
Department of Neurology, the 88th Hospital of PLA [China]
Jing Chen
Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine [United States]
Department of Medicine, Tulane University School of Medicine [United States]
Yonghong Zhang
School of Public Health, Medical College of Soochow University [China]
Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University [China]
Jiang He
Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine [United States]
Department of Medicine, Tulane University School of Medicine [United States]

Keywords: Acute ischemic stroke, Extracellular matrix, Hamilton Rating Scale for Depression, Matrix metalloproteinase-9, Post-stroke depression

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Supplementary material

2019 Volume 83 Issue 11 Pages 2303-2311

DOI https://doi.org/10.1253/circj.CJ-19-0376

Editorial (83-11 pp. 2208-2209)

Browse “Advance online publication” version

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Abstract

Background:Matrix metalloproteinase-9 (MMP-9), a key determinant of extracellular matrix degradation, might cause cerebral damage after stroke and be involved in the development of depressive symptoms. This study aimed to evaluate the association of serum MMP-9 levels and post-stroke depression (PSD).

Methods and Results:Serum MMP-9 levels were determined in 558 acute ischemic stroke patients from 7 hospitals comprising the China Antihypertensive Trial in Acute Ischemic Stroke. We assessed depression status using the 24-item Hamilton Depression Rating Scale and defined PSD as a cutoff score of 8. Logistic regression was performed to estimate the risk of PSD associated with serum MMP-9. Discrimination and reclassification for PSD by MMP-9 were analyzed. A total of 222 (39.8%) stroke patients were categorized as PSD within 3 months. Serum MMP-9 concentrations were higher among PSD patients than those without PSD (658.8 vs. 485.7 ng/mL; P<0.001). The multiple-adjusted odds ratio (95% confidence interval) for the highest MMP-9 quartile compared with the lowest quartile was 4.36 (2.49–7.65) for PSD, and 1 standard deviation higher log-MMP-9 was associated with 68% (37–106%) increased odds of PSD. Adding MMP-9 to the conventional risk factors model substantially improved discrimination and reclassification for PSD (all P<0.05).

Conclusions:Elevated serum MMP-9 levels in the acute phase of ischemic stroke were associated with increased risk of PSD, suggesting an important prognostic role of MMP-9 for PSD.

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