Abstract 15195: MMP-9 Serum Levels Predict Carotid Artery Plaque Progression in Patients without but Not in Patients with Statin Treatment
Background. Matrix metalloproteinase-9 (MMP-9) is expressed in carotid plaques and can reduced by statin treatment. The aim of our study was to examine whether serum levels of MMP-9 are associated with progression of carotid artery atherosclerosis and whether this association is independent of statin treatment.
Methods. We studied 981 of 1286 consecutive patients with neurological asymptomatic carotid atherosclerosis. Patients underwent serial carotid ultrasound investigations with measurements of carotid flow velocities at baseline and after a median of 7.5 months (6 to 9 months). Patients were stratified for statin treatment (statins: n=568, 57.9%; no statins: n=413 42,1%). In addition, patients were prospectively followed for a combined endpoint (death, stroke, and MI) for a median of 3 years (IQR 2.5 - 3.5 years).
Results. Progression of carotid atherosclerosis was found in 85 (8.7 %) patients. In the total cohort, i. e. patients with and without statin treatment, the highest quintile of MMP-9 levels was associated with carotid plaque progression (adjusted OR 2.02 [95%CI 1.22-3.35]; p=0.006). Without statin treatment, MMP-9 levels were significantly higher in patients with carotid plaque progression (p<0.05) as compared to patients without progression. This was not seen in patients with statins (p=0.86). Patients with statin treatment did not show an association between MMP-9 quintiles and atherosclerosis progression (adjusted OR for the highest quintile: 1.40 [95%CI 0.71-2.75]; p=0.33). In contrast, carotid plaque progression was significantly associated with MMP-9 serum levels in patients without statins (adjusted OR for the highest quintile: 3.79 [95%CI 1.69-8.48]; p=0.001). In addition, MMP-9 serum levels predicted adverse outcome (adjusted HRs for the combined endpoint death, stroke, and MI per one standard deviation increase of MMP-9: 1.16 [95%CI 1.02-1.32]; p=0.028)
Conclusion. MMP-9 serum levels are associated with progression of carotid artery atherosclerosis in patients without statin treatment but not in patients that use statins. This data suggests that statins may attenuate the effects of matrix metalloproteinases in the pathogenesis of atherosclerotic plaque progression.
- © 2011 by American Heart Association, Inc.