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.
Full Text:PDF (Русский)
Adams H.P., Bendixen B.H., Kappelle L.J. et al. Classification of subtype of acute ischemic stroke: definitions for use in a multicenter clinical trial: TOAST: Trial of Org 10172 in Acute Stroke Treatment // Stroke. — 1993. — 24. — 35-41.
American College of Cardiology Foundation / American Heart Association Task Force; American Stroke Association; American Association of Neuroscience Nurses; American Association of Neurological Surgeons; American College of Radiology; American Society of Neuroradiology; Congress of Neurological Surgeons; Society of Atherosclerosis Imaging and Prevention; Society for Cardiovascular Angiography and Interventions; Society of Interventional Radiology; Society of NeuroInterventional Surgery; Society for Vascular Medicine; Society for Vascular Surgery; American Academy of Neuro-
logy; Society of Cardiovascular Computed Tomography, Brott T.G., Halperin J.L., Abbara S. et al. 2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS guideline on the management of patients with extracranial carotid and vertebral artery disease: executive summary // J. Neurointerv. Surg. — 2011. — 3(2). — 100-130.
Arenillas J.F., Alvarez-Sabín J., Molina C.A., Chacón P. et al. C-reactive protein predicts further ischemic events in first-ever transient ischemic attack or stroke patients with intracranial large-artery occlusive disease // Stroke. — 2003. — 34(10). — 2463-2468.
Castillo J., Rodriguez I. Biochemical changes and inflammatory response as markers for brain ischaemia: molecular markers of diagnostic utility and prognosis in human clinical practice // Cerebrovasc Dis. — 2004. — 17(Suppl. 1). — 7-18.
Collin C., Wade D.T., Davies S., Horne V. The Barthel ADL Index: a reliability study // Int. Disabil. Stud. — 1988. — 10. — 61-63.
Di Napoli M., Elkind M.S., Godoy D.A. et al. Role of C-reactive protein in cerebrovascular disease: a critical review // Expert. Rev. Cardiovasc Ther. — 2011. — 9(12). — 1565-1584.
Ferrara N., Gerber H.P., LeCouter J. The biology of VEGF and its receptors // Nat. Med. — 2003. — 9. — 669-676.
Greenberg D.A., Jin K. From angiogenesis to neuropathology // Nature. — 2005. — 438. — 954-959.
Hacke W., Kaste M., Fieschi C. et al. Randomised double-blind placebo-controlled trial of thrombolytic therapy with intravenous alteplase in acute ischaemic stroke (ECASS II) // Lancet. — 1998. — 352. — 1245-1251.
Hayashi T., Abe K., Itoyama Y. Reduction of ischemic da-mage by application of vascular endothelial growth factor in rat brain after transient ischemia // J. Cereb. Blood Flow. Metab. — 1998. — 18(8). — 887-895.
Hermann D.M., Zechariah A. Implications of vascular endothelial growth factor for postischemic neurovascular remodeling // J. Cereb. Blood Flow. Metab. — 2009. — 29. — 1620-1643.
Khurana D., Mathur D., Prabhakar S. et al. Vascular endothelial growth factor and monocyte chemoattractant protein-1 levels unaltered in symptomatic atherosclerotic carotid plaque patients from north India // Front Neurol. — 2013. — 4. — 27.
Lo E.H. A new penumbra: transitioning from injury into repair after stroke // Nat. Med. — 2008. — 14. — 497-500.
Luo Y., Wang Z., Li J., Xu Y. Serum CRP concentrations and severity of ischemic stroke subtypes // Can. J. Neurol. Sci. — 2012. — 39(1). — 69-73.
Luque A., Carpizo D.R., Iruela-Arispe M.L. ADAMTS1/METH1 inhibits endothelial cell proliferation by direct binding and sequestration of VEGF165 // J. Biol. Chem. — 2003. — 278. — 23656-23665.
Lyden P.D., Lu M., Levine S. et al. A modified National Institutes of Health stroke scale for use in stroke clinical trials. Preliminary reliability and validity // Stroke. — 2001. — 32. — 1310-1317.
Merrill M.J., Oldfield E.H. A reassessment of vascular endothelial growth factor in central nervous system pathology // J. Neurosurg. — 2005. — 103(5). — 853-868.
Orecchia A., Lacal P.M., Schietroma C. et al. Vascular endothelial growth factor receptor-1 is deposited in the extracellular matrix by endothelial cells and is a ligand for the alpha 5 beta 1 integrin // J. Cell Sci. — 2003. — 116. — 3479-3489.
Pagano P.J., Gutterman D.D. The adventitia: The outs and ins of vascular disease // Cardiovasc Res. — 2007. — 75(4). — 636-639.
Ridker P.M., Hennekens C.H., Buring J.E., Rifai N.
C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women // N. Engl. J. Med. — 2000. — 342. — 836-843.
Ridker P.M., Paynter N.P., Rifai N. et al. C-reactive protein and parental history improve global cardiovascular risk prediction: the Reynolds Risk Score for men // Circulation. — 2008. — 118(22). — 2243-2251.
Ridker P.M., Rifai N., Clearfield M. et al. Measurement of C-reactive protein for the targeting of statin therapy in the primary prevention of acute coronary events // N. Engl. J. Med. — 2001. — 344. — 1959-1965.
Sacks D.B., Arnold M., Bakris G.L. et al. Guidelines and re-commendations for laboratory analysis in the diagnosis and management of diabetes mellitus // Clin. Chem. — 2011. — 57(6). — e1-e47.
Shen F., Walker E.J., Jiang L., Degos V. et al. Coexpression of angiopoietin-1 with VEGF increases the structural integrity of the blood-brain barrier and reduces atrophy volume // J. Cereb. Blood Flow Metab. — 2011. — 31(12). — 2343-51.
Siow R.C.M., Churchman A.T. Adventitial growth factor signalling and vascular remodelling: Potential of perivascular gene transfer from the outside-in // Cardiovascular Research. — 2007. — 75(4). — 659-668.
Sun Y., Jin K., Xie L. et al. VEGF-induced neuroprotection, neurogenesis, and angiogenesis after focal cerebral ischemia // J. Clin. Invest. — 2003. — 111. — 1843-1851.
Takahashi H., Shibuya M. The vascular endothelial growth factor (VEGF)/VEGF receptor system and its role under physiological and pathological conditions // Clin. Sci. (Lond). — 2005. — 109. — 227-241.
Testa U., Pannitteri G., Condorelli G.L. Vascular endothelial growth factors in cardiovascular medicine // J. Cardiovasc Med. — 2008. — 9. — 1190-1221.
Tuttolomondo A., Di Raimondo D., Pecoraro R. et al. Inflammation in Ischemic Stroke Subtypes // Curr. Pharm. Des. — 2012 Feb 29 [Epub ahead of print].
Williams S.V., Fihn S.D., Gibbons R.J.; American College of Cardiology; American Heart Association; American College of Physicians-American Society of Internal Medicine. Guidelines for the management of patients with chronic stable angina: diagnosis and risk stratification // Ann. Intern. Med. — 2001. — 135(7). — 530-547.
Copyright (c) 2016 INTERNATIONAL NEUROLOGICAL JOURNAL
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2020