Predictive Value of Circulating Vascular Endothelial Growth Factor-1 Level Measured Repeatedly During Long-Term Follow-Up in Patients with Arterial Hypertension after Acute Ischemic Stroke

Abstract

Aim: The study aim was to investigate the predictive value of the circulating Vascular Endothelial Growth Factor-1 (VEGF-1) level measured repeatedly in hypertensive patients after acute ischemic stroke.Methods: 102 patients with mild to moderate arterial hypertension, who were evaluated within a 3-week post ischemic stroke period, were included in the study. The circulating VEGF-1 level was measured at baseline and in six months after stroke. Clinical interviews were carried out monthly for a year after stroke. The following are cardiovascular outcomes defined as clinical events: recurrent stroke or transient ischemic attack, ischemic heart disease, sudden death, diabetes mellitus, cardiovascular events, including chronic heart failure and the need for hospital admission for those reasons. Results:The analysis showed an increase in the VEGF-1 concentration, which was associated obviously with the incidence of cardiovascular events within six months after an ischemic stroke when compared with the individuals without an increase in circulating VEGF-1 levels. Adjusted Odds Ratio (OR) for the occurrence of cumulative cardiovascular events in hypertensive patients whose VEGF-1 levels were over 403.57 pg/ml at baseline in comparison with OR in those whose VEGF-1 levels were lower, was equal to 4.11 (95% CI=2.66-7.28; P=0.001). In sixth months, the higher circulating VEGF-1 level was over 450.15 pg/ml in the patients who had its level elevated at baseline in comparison with those who had its level lower at baseline, with the higher VEGF-1 level associated with adjusted odds ratio of 5.46 (95% CI =3.12-7.90; P=0.001). Defined by serial measurements, adjusted OR for the occurrence of cumulative cardiovascular events in hypertensive patients with increased circulating VEGF-1 level was 6.10 (95% CI = 4.70-8.30, P = 0.001) versus the individuals without such a change in VEGF-1 level. Conclusion:We found that incremented circulating VEGF-1 level was an independent predictor of cumulative cardiovascular events in hypertensive patients within a year after an ischemic stroke.