Usefulness of admission matrix metalloproteinase 9 as a predictor of early mortality after cardiopulmonary resuscitation in cardiac arrest patients
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Date
2012
Journal Title
Journal ISSN
Volume Title
Publisher
W B Saunders Co-Elsevier Inc
Access Rights
info:eu-repo/semantics/closedAccess
Abstract
Background: Matrix metalloproteinases (MMPs) have a central role in disease progression after ischemia-reperfusion injury. However, its prognostic significance in cardiac arrest (CA) patients having cardiopulmonary resuscitation (CPR) is unknown. The aim of this study was to investigate the relation between admission MMP-9 level and early mortality in CA patients. Methods: A total of 96 in-hospital or out-of-hospital CA patients and 40 age-and sex-matched healthy volunteers as the control group were evaluated prospectively. The patients were classified according to the CPR response into a successful group (n = 46) and a failed group (n = 50). Results: The MMP-9 levels were detected to be 56.9 +/- 4.3, 69.5 +/- 7.4, and 92.7 +/- 10.1 ng/mL in the control group, the successful CPR group (acute responders), and the failed CPR group, respectively (P < .001 for the 2 comparisons). The MMP-9 level on admission, presence of asystole, mean CA duration, out-of-hospital CPR, sodium and potassium levels, and arterial pH were found to have prognostic significance in univariate analysis. In addition, MMP-9 levels were correlated with age, troponin level, and oxygen saturation. In multivariate logistic regression analysis with forward stepwise method, only MMP-9 level on admission (odds ratio, 1.504; P < .001) and mean CA duration before CPR (odds ratio, 1.257; P = .019) remained associated with post-CPR early mortality after adjustment of other potential confounders. In addition, optimal cutoff value of MMP-9 to predict failed CPR was found as greater than 82 ng/mL, with 88% sensitivity and 97.8% specificity. Conclusions: High MMP-9 levels were associated with worse clinical and laboratory parameters, and it seems that MMP-9 helps risk stratification in CA patients. (C) 2012 Elsevier Inc. All rights reserved.
Description
YILMAZ, MEHMET BIRHAN B/0000-0002-8169-8628; YILMAZ, Mehmet Birhan/0000-0002-8169-8628; YILMAZ, MEHMET BIRHAN/0000-0002-8169-8628; kukul guven, fatma mutlu/0000-0003-3755-6021
WOS: 000311997600021
PubMed: 22633700
WOS: 000311997600021
PubMed: 22633700
Keywords
Journal or Series
American Journal Of Emergency Medicine
WoS Q Value
Q2
Scopus Q Value
N/A
Volume
30
Issue
9
