Predictive Value of Matrix Metalloproteinases and Their Inhibitors for Mortality in Septic Patients: A Cohort Study

Sergio Serrano-Gomez, Gabriel Burgos-Angulo, Daniela Camila Niño-Vargas, María Eugenia Niño, María Eugenia Cárdenas, Estephania Chacón-Valenzuela, Diana Margarita McCosham, Juan Sebastián Peinado-Acevedo, M. Marcos Lopez, Fernando Cunha, Antonio Pazin-Filho, Ramses Ilarraza, Richard Schulz, Diego Torres-Dueñas

Research output: Articles / NotesScientific Articlepeer-review

7 Scopus citations

Abstract

Purpose: Over 170 biomarkers are being investigated regarding their prognostic and diagnostic accuracy in sepsis in order to find new tools to reduce morbidity and mortality. Matrix metalloproteinases (MMPs) and their inhibitors have been recently studied as promising new prognostic biomarkers in patients with sepsis. This study is aimed at determining the utility of several cutoff points of these biomarkers to predict mortality in patients with sepsis. Materials and Methods: A multicenter, prospective, analytic cohort study was performed in the metropolitan area of Bucaramanga, Colombia. A total of 289 patients with sepsis and septic shock were included. MMP-9, MMP-2, tissue inhibitor of metalloproteinase 1 (TIMP-1), TIMP-2, TIMP-1/MMP-9 ratio, and TIMP-2/MMP-2 ratio were determined in blood samples. Value ranges were correlated with mortality to estimate sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiving operating characteristic curve. Results: Sensitivity ranged from 33.3% (MMP-9/TIMP-1 ratio) to 60.6% (TIMP-1) and specificity varied from 38.8% (MMP-2/TIMP-2 ratio) to 58.5% (TIMP-1). As for predictive values, positive predictive value range was from 17.5% (MMP-9/TIMP-1 ratio) to 70.4% (MMP-2/TIMP-2 ratio), whereas negative predictive values were between 23.2% (MMP-2/TIMP-2 ratio) and 80.9% (TIMP-1). Finally, area under the curve scores ranged from 0.31 (MMP-9/TIMP-1 ratio) to 0.623 (TIMP-1). Conclusion: Although TIMP-1 showed higher sensitivity, specificity, and negative predictive value, with a representative population sample, we conclude that none of the evaluated biomarkers had significant predictive value for mortality.

Original languageEnglish
Pages (from-to)95-103
Number of pages9
JournalJournal of Intensive Care Medicine
Volume35
Issue number1
DOIs
StatePublished - 1 Jan 2020

Keywords

  • biomarkers
  • matrix metalloproteinase inhibitors
  • matrix metalloproteinase-2
  • matrix metalloproteinase-9
  • matrix metalloproteinases
  • mortality
  • predictive value
  • sensitivity and specificity
  • sepsis
  • shock

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