P634Vascular endothelial growth factor-1 as a possible marker of vascular remodeling in hypertensive patients after ischemic stroke

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Abstract

Background

Vascular endothelial growth factor-1 (VEGF) has been proposed as a possible marker of acute vascular remodeling and long-term survival after ischemic stroke.

Aim

To evaluate prognostic value of VEGF-1 in comparison to matrix metalloproteinase (MMP)-9 concentration in hypertensive patients after ischemic stroke.

Methods

72 mild-to-moderate arterial hypertension patients (47 male, 56-68 aged) within 1-2 weeks after ischemic stroke were enrolled to the scrutiny and then they were studied prospectively for 6 months period regarding survival rate. Hemispheric location of ischemic focus as leucoareosis was provided by contrast computer tomography at baseline. All enrolled subjects were similar accordingly clinical status, hemodynamic, Rankin score index, and severity of hypertension. Both VEGF-1 and MMP-9 plasma levels were measured at the study entry and in 6 months after baseline by ELISA. All new cardiovascular events including myocardial infarction (MI), unstable angina (UA), recurrence stroke (RS), TIA, advance heart failure (HF) during study period are documented.

Results

Analysis of obtained outcomes have been shown that all cases (n=28) of new cardiovascular events identified during first 4 weeks after start of observation are correlated well with VEGF-1 plasma levels (r=-0.58; P < 0.001) measured at baseline. On the other hand, 4-weeks survival rate was 87.0 % and 68.6% respectively for group subjects (P < 0.01) with top and low quartile of VEGF-1 plasma level at baseline. However, lack of tightly interrelationship between cardiovascular outcomes and VEGF-1 (r=0.2; P=0.16) in 6 months after study entry. The mean MMP-9 plasma levels were significantly higher in dead patients in comparison to survival subjects of the study end. At the same time, MMP-9 plasma levels did not demonstrate a significantly correlation with clinical outcomes during first 4 weeks, except for cases due to advance HF, MI and UA. Both new events associated with RS and TIA incidences independently study period are correlated well with VEGF-1 (r=-0.63; P < 0.05 and r=-0.58; P < 0.02 respectively) only.

Conclusions

We has been proposed that circulating VEGF-1 might have more predicting value in comparison with MMP-9 concentration among hypertensive patients during early ischemic stroke period. The predisposed value of VEGF-1 plasma level toward both RS and TIA incidents during 6 month after stroke could be interesting. The role of circulating MMP-9 plasma level as a prognostic indicator for new cardiovascular events in subjects after 4-weeks ischemic stroke period can be discussed.

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