Abstract
The expression of tissue inhibitor metalloproteinase‐1 (TIMP‐1) significantly increased after acute cerebral ischaemia and involved in neurodegeneration. The purpose was to prospectively investigate the relationship between serum TIMP‐1 with post‐stroke cognitive impairment. Our participants were from an ancillary study of China Antihypertensive Trial in Acute Ischemic Stroke. 598 ischaemic stroke patients from seven participating hospitals were included. Cognitive impairment was evaluated using Mini‐Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) at 3 months. 316 (52.84%) or 384 (64.21%) participants had cognitive impairment according to MMSE or MoCA, respectively. Compared with the first quartile of TIMP‐1, the multivariate‐adjusted odds ratios (95% confidence intervals) for the highest quartile were 1.80 (1.09‐2.97) for cognitive impairment defined by MMSE and 2.55 (1.49‐4.35) by MoCA. Multiple‐adjusted spline regression models showed linear associations between TIMP‐1 concentrations and cognitive impairment (P value for linearity < 0.01). The addition of TIMP‐1 to models including conventional factors improved reclassification for cognitive impairment, as shown by net reclassification index or integrated discrimination improvement (P < 0.05). Participants with both higher TIMP‐1 and matrix metalloproteinase‐9 levels simultaneously had highest risk of cognitive impairment. Higher serum TIMP‐1 levels were associated with increased risk of cognitive impairment after acute ischaemic stroke, independently of established risk factors.
Highlights
Stroke is one of the leading cause of death and long-term disability in the world.[1]
After further adjustment for clinical features, medical histories and other covariates in model 3, compared with the lowest quartile of Tissue inhibitor of metalloproteinase-1 (TIMP-1), the odds ratio (OR) for the highest quartile were 1.80 for cognitive impairment defined by Mini-Mental State Examination (MMSE) and 2.55 by Montreal Cognitive Assessment (MoCA)
Subgroup analyses showed that the relationship between TIMP-1 and cognitive impairment was similar across subgroups stratified according to age, sex, body mass index, admission NIH Stroke Scale (NIHSS) score, smoking status, alcohol consumption, history of hypertension and receiving immediate blood pressure (BP) reduction (Table S2)
Summary
Stroke is one of the leading cause of death and long-term disability in the world.[1]. Previous studies indicated that circulating levels of TIMP-1 significantly increased after acute cerebral ischaemia and played a role in the prognostication of ischaemic stroke.[9,10]. The impact of serum TIMP-1 on subsequent cognitive impairment among patients with ischaemic stroke remains unknown. Our recent study found that serum MMP-9 could be a biomarker for predicting post-stroke cognitive impairment.[14]. We hypothesized that higher TIMP-1 levels in the acute phase could increase the risk of post-stroke cognitive impairment. We studied the relationship between serum TIMP-1 and cognitive impairment in patients with acute ischaemic stroke and investigated whether TIMP-1 provided any predictive value for cognitive impairment. We examined the joint effect of serum TIMP-1 and MMP-9 on the risk of subsequent cognitive impairment
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
