Vascular Endothelial Growth Factor-1 as a Predictor of Unfavorable Cardiovascular Events in Patients with Stage III Essential Hypertension. Results of One-Year Study. Part I
The objective of the study was to evaluate the correlation between circulating vascular endothelial growth factor-1 (VEGF-1) level and incidence of recurrent coronary and cerebral ischemic events in patients with III stage essential hypertension (EH).
Material and Methods. 102 patients with stage III mild-to-moderate essential hypertension were enrolled in the study in 3 weeks after ischemic stroke. Follow-up period was 12 months period with 3-month intervals. Circulating VEGF-1 level was determined once at baseline. Clinical interviews were performed every 3 months during 1 year after blood sampling. All cardiovascular outcomes were considered as clinical endpoints.
Results. Analysis of obtained data have been showed that medians of circulating VEGF-1 levels in patients with stage III EH, which have demonstrated 1, 2, 3 or more cases of recurrent cardiovascular events, were 373.80 pg/ml (95% CI 342.90–479.70 pg/ml),
539.96 pg/ml (95% CI 444.28–865.56 pg/ml), and 724.66 pg/ml
(95% CI 558.72–890.66 pg/ml), respectively, and they were significantly higher than that of in persons for whom the new clinically relevant cardiovascular outcomes have not been reported (Me 289.28 pg/ml; 95% CI 279.71–345.88 pg/ml)
(P = 0.001 for all cases). The cutoff point of VEGF-1 with most optimal predictive value for reccurent cardiovascular events was equal to 403.57 pg/ml (area under the curve = 0.76; 95% CI 0.602–0.917; P = 0.001), when sensitivity and specificity were 78.6 and 70.0 %, respectively. In this case, when circulating VEGF-1 level was more than 403.57 pg/ml, the number of reported cardiovascular events during one year of follow-up was significantly higher in comparison with patients with lower VEGF-1 level (OR 4.11; 95% CI 2.66–7.28; P = 0.001).
Conclusion. Circulating level of vascular endothelial growth factor-1 is an independent predictor of cumulative cardiovascular outcomes in hypertensive patients with stage III essential hypertension for 1 year after cerebral ischemic stroke.
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