MMP-9 levels in elderly patients with cognitive dysfunction after carotid surgery

John G. Gaudet, Gene T. Yocum, Susie S. Lee, Anna Granat, Maya Mikami, E. Sander Connolly, Eric J. Heyer

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Approximately 25% of elderly patients scheduled for carotid endarterectomy (CEA) develop post-operative cognitive dysfunction (CD). We tested the hypothesis that the plasma levels of matrix metalloproteinase 9 (MMP-9) are predictive of moderate to severe CD after CEA. A total of 73 patients were prospectively enrolled in this Institutional Review Board-approved study. Plasma samples were obtained at baseline and day 1 post-surgery. We measured the plasma concentrations of both MMP-9 and its inhibitor, tissue inhibitor of metalloproteinases 1 (TIMP-1). We estimated the MMP-9 activity by calculating the MMP-9:TIMP-1 ratio. The cognitive performance day 1 post-surgery was quantified with z-scores, using a control group who were undergoing spinal surgery. The criteria used to define CD was performance of ≥1.5 standard deviations worse than the control group; approximately 19% of eligible patients developed CD. Compared to patients without CD, this group had both higher total (81.66 ± 12.25 ng/mL versus [vs.] 43.18 ± 4.44 ng/mL, p = 0.005) and activity (0.88 ± 0.24 ng/mL vs. 0.54 ± 0.06 ng/mL, p = 0.003) MMP-9 levels at baseline. All of the results were adjusted for age, diabetes and neurovascular symptoms.

Original languageEnglish (US)
Pages (from-to)436-440
Number of pages5
JournalJournal of Clinical Neuroscience
Issue number4
StatePublished - Apr 2010
Externally publishedYes


  • Aged 60 and over
  • Carotid
  • Cognition disorders
  • Endarterectomy
  • Matrix metalloproteinase 9
  • Post-operative complications

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology
  • Physiology (medical)


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