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Usefulness of admission matrix metalloproteinase 9 as a predictor of early mortality after cardiopulmonary resuscitation in cardiac arrest patients

Date

2012

Author

Turkdogan, Kenan Ahmet
Zorlu, Ali
Guven, Fatma Mutlu Kukul
Ekinozu, Ismail
Eryigit, Umut
Yilmaz, Mehmet Birhan

Metadata

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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.

Source

AMERICAN JOURNAL OF EMERGENCY MEDICINE

Volume

30

Issue

9

URI

https://dx.doi.org/10.1016/j.ajem.2012.02.017
https://hdl.handle.net/20.500.12418/8962

Collections

  • Makale Koleksiyonu [5200]
  • Makale Koleksiyonu [5745]
  • Öksüz Yayınlar Koleksiyonu - WoS [6162]



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