Associations of matrix metalloproteinase-9 and monocyte chemoattractant protein-1 concentrations with carotid atherosclerosis, based on measurements of plaque and intima-media thickness

Abstract

Purpose: To examine associations of matrix metalloproteinase-9 (MMP-9) and monocyte chemoattractant protein-1 (MCP-1) concentrations with the severity of carotid atherosclerosis, based on measurements of carotid plaque and intima-media thickness (IMT).

Methods: This cross-sectional study included 116 stroke-free participants (45.7% males, 54.3% females; mean age, 64.73 ± 14.53 years). Serum MMP-9 and MCP-1 concentrations were measured, and plaque morphology, including total plaque score (PS), plaque stability, and IMT, was assessed ultrasonographically. Participants were grouped according to total PS (0, 1-2, ≥ 3), plaque stability (no plaque, stable, unstable) and IMT tertiles (<0.8 mm, 0.8-1 mm, >1 mm). Multinomial logistic regression models were used to assess the associations of MMP-9 and MCP-1 concentrations with plaque and IMT values after adjusting for vascular risk factors.

Results: MMP-9 quartiles (vs. quartile 1) were significantly associated with a greater prevalence of plaque instability [Q2: odds ratio (OR) = 5.13, 95% confidence interval (CI) = 1.01-24.9, p = 0.042; Q3: OR = 15.5, 95% CI = 3.1-78.1, p = 0.001; Q4: OR = 13.2, 95% CI = 2.7-64.97, p = 0.001] and high total PS (Q3: OR = 10.02, 95% CI = 1.5-65.33, p = 0.016; Q4: OR = 21.5, 95% CI = 3.5-132.1, p = 0.001). MCP-1 concentration was significantly associated with IMT (OR = 22.94, 95% CI = 2.14-245.66, p = 0.01).

Conclusions: Elevated serum MMP-9 concentration was independently associated with high total carotid artery PS, plaque instability, and large IMT value. MCP-1 concentration was independently associated with IMT, but not with plaque morphology.

Keywords: Carotid atherosclerosis; Intima–media thickness; Plaque score; Serum matrix metalloproteinase-9; Serum monocyte chemoattractant protein-1.