The association between plasma matrix metalloproteinase-9 concentration and endoleak after endovascular aortic aneurysm repair: a meta-analysis

Ng, Eugene, Morris, Dylan R., and Golledge, Jonathan (2015) The association between plasma matrix metalloproteinase-9 concentration and endoleak after endovascular aortic aneurysm repair: a meta-analysis. Atherosclerosis, 242 (2). pp. 535-542.

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Abstract

Background: The most common complication after endovascular aneurysm repair (EVAR) is continued perfusion of the aneurysmal sac, known as endoleak. Assessment of markers released from the aneurysm wall into the circulation has been suggested as a possible alternative for detecting endoleaks. The aim of this meta-analysis was to examine if circulating concentrations of matrix metalloproteinase (MMP)-9 were higher in patients with endoleak after EVAR.

Methods: A systematic search of the MEDLINE, EMBASE, Scopus, Web of Science and Cochrane Library Databases was conducted. Studies reporting circulating MMP-9 concentrations in patients who did and did not have endoleaks after EVAR that met inclusion and exclusion criteria were included. A meta-analysis using a random effects model was performed to assess the association between circulating concentrations of MMP-9 and endoleak. Sensitivity analyses were performed using the one-study remove approach. Study quality was assessed using a quality assessment tool.

Results: Prior to EVAR, plasma concentrations of MMP-9 were similar in patients that did and did not subsequently develop an endoleak (Standardised mean difference: −0.13; 95% confidence interval, −0.63 to 0.37, p = 0.60). 1 month after EVAR, plasma concentrations of MMP-9 were non-significantly higher in patients that had an endoleak (Standardized mean difference: 0.56; 95% CI −0.02 to 1.15, p = 0.06). 3 months after EVAR, plasma concentrations of MMP-9 were higher in patients that had an endoleak (Standardised mean difference: 1.42; 95% confidence interval, 0.48–2.36, p < 0.003).

Conclusions: This meta-analysis suggests that plasma MMP-9 concentrations measured 3 months after EVAR are higher in patients that have an endoleak. It remains to be established whether plasma MMP-9 testing is sufficiently accurate for use as a surveillance test for endoleak after EVAR.

Item ID: 42023
Item Type: Article (Research - C1)
ISSN: 1879-1484
Keywords: biomarkers; endovascular repair of aneurysm; EVAR; endoleak; plasma markers; circulating markers
Funders: National Health and Medical Research Council (NHMRC), Queensland Government, Senior Clinical Research Fellowship, Townsville Hospital Private Practice Trust Fund (THPPTF)
Projects and Grants: NHMRC 1079369 , NHMRC 1079193, NHMRC 1063476, NHMRC 1019921, NHMRC 1022752, NHMRC 1003707, NHMRC 1021416, NHMRC 1000967
Date Deposited: 08 Dec 2015 18:35
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1102 Cardiovascular Medicine and Haematology > 110201 Cardiology (incl Cardiovascular Diseases) @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920103 Cardiovascular System and Diseases @ 100%
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