Background: Stroke is a heterogeneous and multi-factorial disease that affects people globally. Matrix Metalloproteinase-9 is involved in the pathogenic events that occur during an ischemic stroke.MMP-9 concentration is related to infarct extension, neurologic impairments, and hemorrhagic transformation in ischemic stroke.

Objective: Improving individuals' outcomes after having an acute ischemic stroke by assessing MMP-9 serum level 24 hours after the stroke begins and the relation between Serum levels of MMP-9 , clinical severity, and ischemic stroke prognosis. Methods: This follow up prospective research was conducted at Zagazig University Hospitals' Emergency and Stroke Units, Neurology Department . Fifty-four subjects with first acute ischemic stroke were recruited . Stroke severity and serum MMP-9 level were assessed on admission and following a 15-day follow-up.

Results: Serum MMP-9 was 1085.93 ng/ml. Significant positive correlation was found between serum MMP-9 and neurological severity as measured by NIHSS at admission and after 15 days.There was highly significant positive correlation between MMP-9 and functional outcome as assessed by mRS after 15 days follow up. The best cutoff of MMP-9 in prediction of large size infarction was ≥ 1042ng/ml , the best cutoff of MMP-9 in prediction of severe stroke was ≥ 1091ng/ml. The best cutoff of MMP-9 in prediction of severe stroke after 15 days was ≥972.5 ng/ml. MMP-9, size of infarct, BI and mRS were significantly independently associated with baseline NIHSS among studied patients.

Conclusion: Serum MMP-9 may act as potential prognostic factor predicting neurological severity and short term outcome in individuals with ischemic stroke.