Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.202401631
Jornal Vascular Brasileiro
Artigo Original

Expression of plasma levels of MMP-2, MMP-9, TIMP-1, and TIMP-2 in patients with abdominal aortic aneurysms

Expressão plasmática de MMP-2, MMP-9, TIMP-1 e TIMP-2 em pacientes com aneurisma da aorta abdominal após evar

Túlio Fabiano de Oliveira Leite; Elpidio Ribeiro da Silva; Karoline Gomes; Daniela Pretti da Cunha Tirapelli; Edwaldo Edner Joviliano

http://dx.doi.org/10.1590/1677-5449.202401631 J Vasc Bras, vol.24, e20240163, 2025
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Abstract

Background: Endovascular aneurysm repair (EVAR) is now considered the preferred treatment modality in most abdominal aortic aneurysm (AAA) patients.

Objectives: The objective of this study was to quantify and evaluate MMP-2, MMP-9, TIMP-1, and TIMP-2 expression response to EVAR based on serum assays at 6-month follow-up.

Methods: 47 patients with AAA who underwent EVAR and ten people with no comorbidities were recruited for the study. Plasma levels of MMPs and TIMPs were assayed by ELISA preoperatively and after 6 months in the group submitted to EVAR and only once in the control group. Demographic profiles, clinical follow-up data, and imaging exams with angiotomography performed preoperatively and after 6 months were collected.

Results: Forty-seven patients with AAA were treated with EVAR. 87.2% of these patients were male and 68.08% were smokers. There were no deaths in the first 30 days. Ten patients (21.27%) had an endoleak during the 6-month postoperative period. Higher MMP and TIMP levels were observed in the AAA patients compared with patients in the control group, although without statistical significance. After EVAR, there were increases in MMP and TIMP levels both in the group with endoleaks and in the group without endoleaks (p<0.05). The variables related to demographic and anatomical data and types of devices used by the patients did not show statistical significance, except for a significant reduction in aneurysmal sac diameter (p<0.05).

Conclusions: None of the markers assessed showed any association with endoleak status. However, the concentrations of MMPs and TIMPs in circulation increased in all patients after EVAR. Collectively, these findings suggest that the markers assessed have little potential to influence current post-EVAR monitoring practices.

Keywords

abdominal aortic aneurysm; endovascular aneurysm repair; matrix metalloproteinase; tissue inhibitors of metaloproteinases; endoleaks

Resumo

Contexto: A correção endovascular de aneurisma da aorta (EVAR) é a modalidade de tratamento preferencial para a maioria dos pacientes com aneurisma da aorta abdominal (AAA). O objetivo deste estudo foi quantificar e avaliar os níveis séricos de MMP-2, MMP-9, TIMP-1 e TIMP-2 6 meses após o procedimento.

Objetivos: O objetivo deste estudo foi quantificar e avaliar a resposta da expressão de MMP-2, MMP-9, TIMP-1 e TIMP-2 ao EVAR com base em ensaios séricos no acompanhamento de 6 meses.

Métodos: Foram incluídos 47 pacientes com AAA indicados para EVAR; apenas 10 não tinham comorbidades. A determinação plasmática de MMP-2, MMP-9, TIMP-1 e TIMP-2 foi realizada por ELISA no pré-operatório e aos 6 meses no grupo EVAR e apenas uma vez no grupo controle. Foram coletados dados demográficos, clínicos e exames de angiotomografia realizados no pré-operatório e após 6 meses.

Resultados: Dos 47 pacientes tratados com EVAR, 87,2% eram homens e 68,1%, fumantes. Não houve óbitos em 30 dias, e 10 pacientes (21,27%) apresentaram endoleak no pós-operatório. Embora os níveis de MMP-9, MMP-2, TIMP-1 e TIMP-2 tenham sido mais elevados em pacientes com AAA do que no grupo controle, essa diferença não alcançou significância estatística. Observou-se, porém, um aumento significativo desses biomarcadores tanto no grupo com quanto sem endoleak após EVAR (p<0,05). As variáveis ​​estudadas relacionadas aos dados demográficos e anatômicos e tipo de dispositivo não apresentaram significância estatística, exceto por uma redução significativa no diâmetro do saco aneurismático (p<0,05).

Conclusões: Nenhum dos marcadores avaliados mostrou associação com a ocorrência de endoleak. No entanto, as concentrações circulantes de MMPs e TIMPs aumentaram em todos os pacientes após EVAR. Coletivamente, esses achados sugerem que os marcadores avaliados têm pouco potencial para influenciar as práticas atuais de monitoramento pós-EVAR.

Palavras-chave

aneurisma da aorta abdominal; reparo endovascular de aneurisma; metaloproteinase da matriz; inibidores teciduais de metaloproteinases; vazamentos internos

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Submetido em:
16/11/2024

Aceito em:
08/02/2025

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