Prognostic value of plasma fibroblast growth factor 21 among patients with acute ischemic stroke

Abstract

Background and purpose To evaluate the association between plasma fibroblast growth factor 21 (FGF‐21) and clinical outcomes in patients with acute ischemic stroke. Methods A total of 3412 acute ischemic stroke patients from the China Antihypertensive Trial in Acute Ischemic Stroke with plasma FGF‐21 measurements were included in this analysis. The primary outcome was a combination of death or major disability (modified Rankin Scale score ≥3) within 1 year after stroke. Results During the 1‐year of follow‐up, 745 (21.83%) patients experienced the primary outcome; 550 had a major disability and 195 died. After multivariate adjustment, higher plasma FGF‐21 was significantly associated with increased risk of the primary outcome (odds ratio = 1.52, 95% confidence interval = 1.11–1.29). Each 1‐SD increase of log‐transformed FGF‐21 (0.67 pg/ml) was associated with 19%, 3%, and 33% increased risk of the primary outcome, major disability, and death, respectively. The addition of FGF‐21 to the conventional risk factors significantly improved prediction of the primary outcome in ischemic stroke patients (net reclassification index = 10.8%, p = 0.011; integrated discrimination improvement = 0.3%, p = 0.038). Conclusions Higher plasma FGF‐21 was associated with poor prognosis in acute ischemic stroke patients, suggesting that FGF‐21 may be a prognostic marker for ischemic stroke.

Circulating serum fibroblast growth factor 21 as risk and prognostic biomarker of retinal artery occlusion

“…Acute cerebral infractions were found in 27.0-76.4% of CRAO patients with magnetic resonance imaging with diffusion-weighted imaging 42 , suggesting that these patients warrant urgent stroke assessment. Recent studies showed FGF21 levels are elevated in ischemic stroke and associated with poor prognosis 43,44 . Controversially, FGF21 played a protective role in stroke.…”

Increased serum fibroblast growth factor 21 levels are associated with adverse clinical outcomes after intracerebral hemorrhage

“…Additionally, Ong et al (2019) and Wu et al (2022) revealed that the amount of serum FGF21 was linked with the prognosis of several cardiovascular illnesses. Moreover, only one cohort study evaluated the prognostic value of serum FGF21 among patients with acute ischemic stroke (Zheng et al, 2021). Nevertheless, serum FGF21 and its association with unfavorable outcomes have yet to be assessed in a prospective multicenter cohort with ICH.…”

Body fluids biomarkers associated with prognosis of acute ischemic stroke: progress and prospects

“…In addition, plasma endostatin [ 76 ], brain natriuretic peptide (BNP) [ 77 , 78 ], serum ferritin [ 79 , 80 ], plasma fibroblast growth factor [ 81 ], plasma trimethylamine-N-oxide content [ 82 ], hypersensitive cardiac troponin [ 83 ], coagulant-related factors C-type lectin receptor 2 and anti-phosphatidylserine [ 84 , 85 ], circulating IGF-1 [ 86 ], plasma lipid metabolism [ 87-89 ], plasma D-dimer [ 90 ] and other biochemical metabolites may be related to the prognosis of AIS. For example, Yang et al prospectively included patients with AIS pneumonia associated with atrial fibrillation (AF) and found significant increases in 3-month mortality and severe residual risk associated with high D-dimer levels and pneumonia AIS, suggesting that plasma D-dimer has prognostic value [ 91 ].…”