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Background   Although the level of serum vascular endothelial growth factor (VEGF) is elevated in coronary artery disease (CAD) patients, its potential role in acute coronary syndrome (ACS) or stable angina pectoris (SAP) patients remains unclear.Objectives   To evaluate diagnostic accuracy of serum VEGF in determining ACS patients from SAP and analyze the association of serum VEGF with coronary artery lesions in SAP or the GRACE score in ACS, which is involved in the poor prognosis of low serum VEGF.Methods   248 CAD patients and 48 healthy subjects were enrolled in this study. Serum VEGF levels were detected by using ELISA. The Gensini score or GRACE score was calculated among SAP or ACS patients. All the patients were followed up for a period of 12 months (mean: 10.77 months).Results   VEGF serum concentrations were higher in the ACS subgroup than in the SAP subgroup ( P  < 0.001) with diagnostic accuracy of ACS from SAP (AUC: 0.667, sensitivity: 68.5%, specificity: 60.1%,  P  < 0.001). Patients with high risk of Gensini score showed reduced VEGF levels ( P  < 0.001) accompanied by a negative correlation ( r  = −0.396,  P  < 0.001). Patients with a higher GRACE score indicated lower VEGF levels ( P  < 0.001). Low serum VEGF was one of the potential risk factors with adjusted HR of 0.531 ( P =0.048).Conclusion   Serum VEGF exhibits efficient diagnostic value for detection of ACS from SAP with a cutoff value of 648.75 pg/mL. Low serum VEGF indicates severe coronary artery lesions and a higher GRACE score, which suggests poor clinical outcomes.

Serum VEGF: Diagnostic Value of Acute Coronary Syndrome from Stable Angina Pectoris and Prognostic Value of Coronary Artery Disease