OP 70. When Should We Measure Matrix Metalloproteinase-9 and Tissue Inhibitor of Metalloproteinase-1 Regarding Postoperative Cognitive Dysfunction after Carotid Surgery?
B. Nagy, G. Woth, A Mérei, L. Nagy, J. Lantos, G. Menyhei, L. Bogár, D. Mühl
Chair(s): Roland Demaria, Mustafa Cikirikcioglu & Violetta Kékesi
8:40 - 8:50h
at Buda Room (B)
Categories: Cardiac and Vascular Surgery, Oral Session
Session: Oral Session VIII - Cardiac and Vascular Surgery II
Background
Carotid endarterectomy (CEA) is performed day by day worldwide and is considered a safe intervention regarding major complications. Post-operative cognitive dysfunction (POCD) is however a frequent (20-30%) subtle complication and is now the focus of significant interest. Recent publications examine MMP-9 - TIMP-1 system in CEA and CEA related POCD, although nobody have evaluated the exact perioperative time course yet. We aimed therefore to describe this possible important and missing point.
Material and Methods
Patients scheduled for elective CEA (n=54) were considered for enrollment. Age and gender matching atherosclerotic patients (n=20) were served as controls. Blood sampling was performed at four time points: preoperatively, one hour postoperatively, first and third postoperative morning.
Result
We observed significant elevation of MMP-9 only at first postoperative morning compared to preoperative values. Regarding TIMP-1 no difference is experienced preoperatively, but we measured significantly decreased TIMP-1 immediately after CEA and TIMP-1 remained at this level until first postoperative morning. MMP-9/TIMP-1 increased significantly right after CEA and increased further until first postoperative day. However, compared to controls, we noted significantly elevated MMP-9 and MMP-9/TIMP-1 ratios at all time points.
Conclusion
Our study provides information on the perioperative dynamics of MMP-9-TIMP-1 system. Based on our results, we could recommend measuring of MMP-9 and TIMP-1 preoperatively and at the first postoperative morning. Our results should be considered in case of study planning in the field of MMP-9-TIMP-1 system in CEA and associated disorders.
