{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T02:30:51Z","timestamp":1782786651668,"version":"3.54.5"},"reference-count":52,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,10,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Spontaneous vertebral arterial dissection (VAD) is an important cause of posterior circulation ischemic stroke (PCS), but its pathogenesis remains elusive. Matrix metalloproteinase 9 (MMP\u20109) is a gelatinase involved in inflammation process and several vascular diseases, such as aorta dissection, but its role in VBD is unclear yet. The present study aimed to determine the association between serum MMP\u20109 level and VAD\u2010related PCS.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We recruited 149 patients with PCS, of which 30 were VAD and 119 had other determined etiologies (non\u2010VAD), and 219 non\u2010stroke individuals. Serum MMP\u20109 was measured within 14\u00a0days from stroke onset. The age of VAD group was 59.6\u00b115.0\u00a0years, which is similar to non\u2010stroke group (\n              <jats:italic>P<\/jats:italic>\n              =0.510) but significantly younger than non\u2010VAD group (69.9\u00b114.0\u00a0years,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Males and vascular risk factors were significantly more prevalent in VAD and non\u2010VAD groups than non\u2010stroke group (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Multivariate logistic regression analysis adjusting potential confounders revealed that every 100\u00a0ng\/mL of serum MMP\u20109 level increment significantly predicted VAD (versus non\u2010stroke group: odds ratio (OR), 4.572; 95% CI, 2.240\u20139.333,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001; versus non\u2010VAD group: OR, 1.819; 95% CI, 1.034\u20133.200,\n              <jats:italic>P<\/jats:italic>\n              =0.038).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Patients with VAD\u2010related PCS had higher levels of serum MMP\u20109 at the acute stage of stroke compared with non\u2010stroke individuals and PCS of other causes, supporting the potential involvement of extracellular matrix\u2010degrading protease in the mechanism of VAD, which leads to ischemic events.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.016743","type":"journal-article","created":{"date-parts":[[2020,9,12]],"date-time":"2020-09-12T12:49:26Z","timestamp":1599914966000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Involvement of Matrix Metalloproteinase 9 in Vertebral Arterial Dissection With Posterior Circulation Ischemic Stroke"],"prefix":"10.1161","volume":"9","author":[{"given":"Chun\u2010Yu","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Neurology Neurological Institute Taipei Veterans General Hospital Taipei Taiwan"},{"name":"Department of Neurology National Yang\u2010Ming University Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng\u2010Chi","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Radiology Taipei Veterans General Hospital Taipei Taiwan"},{"name":"Department of Neurology National Yang\u2010Ming University Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5344-6685","authenticated-orcid":false,"given":"I\u2010Hui","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology Neurological Institute Taipei Veterans General Hospital Taipei Taiwan"},{"name":"Department of Neurology National Yang\u2010Ming University Taipei Taiwan"},{"name":"Institute of Brain Science School of Medicine National Yang\u2010Ming University Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9419-9070","authenticated-orcid":false,"given":"Chih\u2010Ping","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Neurology Neurological Institute Taipei Veterans General Hospital Taipei Taiwan"},{"name":"Department of Neurology National Yang\u2010Ming University Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.188"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.30.5.1083"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/159101991201800414"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-803058-5.00077-1"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.38.6.868"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1159\/000437172"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2019.07.022"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/res.90.3.251"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/bs.apha.2017.08.002"},{"key":"e_1_3_1_11_2","first-page":"391","article-title":"Matrix metalloproteinase\u20109: many shades of function in cardiovascular disease","author":"Yabluchanskiy A","year":"2013","unstructured":"Yabluchanskiy A, Ma Y, Iyer RP, Hall ME, Lindsey ML. 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