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Vascular endothelial growth factor and poor prognosis after ischaemic stroke
Author(s) -
Escudero Carlos,
Acurio Jesenia,
López Eduardo,
Rodríguez Andrés,
Benavente Antonia,
Lara Evelyn,
Korzeniewski Steven J.
Publication year - 2021
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.14641
Subject(s) - medicine , modified rankin scale , vascular endothelial growth factor , stroke (engine) , area under the curve , receiver operating characteristic , logistic regression , angiogenesis , neurotrophic factors , endothelial dysfunction , gastroenterology , cardiology , vegf receptors , ischemia , ischemic stroke , mechanical engineering , receptor , engineering
Background and purpose Systemic inflammation conveys information about ischaemic stroke prognosis. Growth factors with neurotrophic and angiogenesis‐regulating properties might provide additional information about sequelae. The prognostic performance of circulating vascular endothelial growth factor (VEGF), placental growth factor, interleukin 6 and C‐reactive protein measured after acute ischaemic stroke was evaluated. Methods Blood samples were collected from n = 45 patients within 24–48 h of acute ischaemic stroke. The primary outcome was death or moderate to severe disability at 6 months (modified Rankin Scale >2). Logistic regression models were used to determine the area under the receiver operating characteristic curve (AUC). Correlation and principal component analyses were performed to examine interrelationships amongst biomarkers. Results Vascular endothelial growth factor was elevated in ischaemic stroke patients who died or had moderate to severe disability at six months. Correlation analysis revealed interrelationships between VEGF and HbA1c, triglycerides, erythrocyte sedimentation rate and National Institutes of Health Stroke Scale and Rankin scores, whereas principal component analyses identified VEGF as a major loading factor that discriminated good from poor prognosis. There were no significant differences in AUC using each protein individually to identify patients who had modified Rankin Scale score >2 at 6 months ( n = 15/41, AUC 0.61–0.74). However, the AUC increased significantly when combining VEGF with interleukin 6 and C‐reactive protein compared to the VEGF‐only model (AUC 0.92 vs. 0.67, p = 0.02). Conclusion Circulating VEGF was elevated 24–48 h after acute ischaemic stroke and conveyed prognostic information about moderate to severe disability at 6 months.