LEVELS OF MATRIX METALLOPROTEINASES IN PATIENTS WITH ISCHEMIC STROKE OF DIFFERENT ETIOLOGIES

Introduction. Ischemic stroke remains one of the leading causes of mortality and long-term disability worldwide. A particularly pressing issue is the differential diagnosis of its subtypes, notably cardioembolic (CE) and atherothrombotic (AT) strokes, which differ significantly in terms of pathogenesis, clinical presentation, and prognosis. The identification of biomarkers capable of reflecting stroke severity or serving as potential diagnostic indicators remains a scientific challenge. This study aimed to assess the plasma levels of matrix metalloproteinases (MMPs), particularly MMP-2 and MMP-9, as well as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), in patients with CE and AT stroke to evaluate their potential as differential diagnostic and prognostic markers. Methods. The study included 122 patients with ischemic stroke admitted to the neurology department of Kyiv City Clinical Hospital No. 4 between 2016 and 2020. Based on comprehensive clinical assessment, neuroimaging, and detailed medical history, patients were categorized into two groups: those with atherothrombotic stroke (AT, n=66) and those with cardioembolic stroke (CE, n=56). A control group comprised 35 healthy individuals. Biomarker levels were measured in plasma samples using enzyme-linked immunosorbent assay (ELISA). Results. Significantly elevated plasma levels of MMP-2, MMP-9, IL-6, and TNF-α were observed in both patient groups compared to controls (p < 0.05). Median concentrations of all four biomarkers were higher in the CE group; however, intergroup differences between CE and AT subtypes did not reach statistical significance. These findings suggest a possible association between biomarker levels and the severity of ischemic injury, though the lack of subtype specificity limits their differential diagnostic utility. Conclusions. Matrix metalloproteinases (MMP-2 and MMP-9) and proinflammatory cytokines (IL-6 and TNF-α) demonstrate potential as biomarkers of ischemic stroke severity. Their levels are significantly elevated in the acute phase of the disease, yet they do not allow for reliable differentiation between atherothrombotic and cardioembolic subtypes. Further studies should focus on the dynamic profiling of these biomarkers in conjunction with other clinical and laboratory indicators to support personalized stroke management strategies.