Abstract WP66: Metalloproteinase-9 Higher Increase After Thrombolysis Is Associated With Hemorrhagic Transformation Of Lesion And With Poor Stroke Outcome

Background and Purpose: In experimental animals metallo-proteinases (MMPs) play a detrimental role related to severity and hemorrhagic transformation of the ischemic lesion. tPA enhances and MMPs inhibitors (TIMPs) antagonize such effects. This study aimed to expand clinical evidence in this connection. Methods: Blood was taken at baseline and 24 hours after from 327 patients (mean age 68, mean NIHSS 11.9) with acute ischemic stroke, all treated with i.v. tPA thrombolysis within 4.5 hours. MMPs 1, 2, 3, 7, 8, 9, and TIMPs 1, 2, 4 were measured (in ng/ml) using Bio-plex suspension array system and RD TIMP4 0.67 vs. 0.22 p 0.015]. 2) Death vs. survival: significant for MMPs 1, 8, 9 and TIMP1 [MMP1: 0.01 vs. -0.14 p .048; MMP8: 0.46 vs. -0.09 p .011; MMP9: 0.37 vs. -0.17 p .007; TIMP1 0.17 vs. -0.02 p .011]. 3) mRS 3-6 vs. 0-2: significant for MMPs 8, 9, and TIMP 4 [MMP8: 0.12 vs. -0.17 p Conclusions: our data add substantial clinical evidence about MMP-9 as detrimental factor in ischemic stroke treated with thrombolysis, and may prompt RCTs testing of TIMPs in combination with tPA.