AUTHOR=Mechtouff Laura , Bochaton Thomas , Paccalet Alexandre , Crola Da Silva Claire , Buisson Marielle , Amaz Camille , Bouin Morgane , Derex Laurent , Ong Elodie , Berthezene Yves , Eker Omer Faruk , Dufay Nathalie , Mewton Nathan , Ovize Michel , Nighoghossian Norbert , Cho Tae-Hee 

TITLE=Matrix Metalloproteinase-9 Relationship With Infarct Growth and Hemorrhagic Transformation in the Era of Thrombectomy

JOURNAL=Frontiers in Neurology

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2020.00473

DOI=10.3389/fneur.2020.00473

ISSN=1664-2295

ABSTRACT=<p><bold>Objective:</bold> To assess the relationship between matrix metalloproteinase 9 (MMP-9), a proteolytic enzyme involved in the breakdown of the blood-brain barrier, and infarct growth and hemorrhagic transformation in acute ischemic stroke (AIS) with large vessel occlusion (LVO) in the era of mechanical thrombectomy (MT) using the kinetics of MMP-9 and sequential magnetic resonance imaging (MRI).</p><p><bold>Methods:</bold> HIBISCUS-STROKE is a cohort study including AIS patients with LVO treated with MT following admission MRI. Patients underwent sequential assessment of MMP-9, follow-up CT at day 1, and MRI at day 6. The CT scan at day 1 classified any hemorrhagic transformation according to the European Co-operative Acute Stroke Study-II (ECASS II) classification. Infarct growth was defined as the difference between final Fluid-Attenuated Inversion Recovery volume and baseline diffusion-weighted imaging volume. Conditional logistic regression analyses were adjusted for main confounding variables including reperfusion status.</p><p><bold>Results:</bold> One hundred and forty-eight patients represent the study population. A high MMP-9 level at 6 h from admission (H6) (<italic>p</italic> = 0.02), a high glucose level (<italic>p</italic> = 0.01), a high temperature (<italic>p</italic> = 0.04), and lack of reperfusion (<italic>p</italic> = 0.02) were associated with infarct growth. A high MMP-9 level at H6 (<italic>p</italic> = 0.03), a high glucose level (<italic>p</italic> = 0.03) and a long delay from symptom onset to groin puncture (<italic>p</italic> = 0.01) were associated with hemorrhagic transformation.</p><p><bold>Conclusions:</bold> In this MT cohort study, MMP-9 level at H6 predicts infarct growth and hemorrhagic transformation.</p>