Vascular endothelial growth factor-1 level and functional neurologic recovery after ischemic hemispheric stroke

Abstract

Abstract. Background: Vascular endothelial growth factor-1 (VEGF-1) acts as endogeneous angiopoetic and neuroprotective factor. The aim of the study to investigate an interrelationship between VEFG-1 elevation and neurologic recovery in short-term period among patients with ischemic hemispheric stroke. Methods: Seventy eight patients with ischemic hemispheric stroke were included in the study. Neurological impairment at presentation was assessed according National Institute of Health Stroke Scale. The Barthel Index and the modified Rankin Scale (mRS) were used to assess functional disability. Concentrations of VEGF-1 were measured at baseline using ELISA laboratory kit. Results: The total prevalence of hypertension was 100% (78 patients). 79.5% patients had dyslipidemia, 18% were diabetic, 15.4% of the total population was smokers. Among study patient population a total of 19.2% subjects had a past history of ischemic heart diseases in their families and 11.5% had experienced a previous ischemic heart episode. Within 6 month after baseline the favorable neurologic recovery defined as mRS ≤ 2 was found in 64 patients (82.1%). We calculated Modified Rankin Score ≥ 3 in 14 patients (17.9%). Depending on Modified Rankin Score at 6 month (≤ 2 and ≥ 3) we have divided all patients into two sub-groups respectively. We found a higher prevalence of subjects with dyslipidemia (P=0.044), diabetes mellitus (P=0.024), smokers (P=0.025) and as well as those with ischemic heart disease in their family histories (P=0.026) and previous ischemic heart episode (P=0.032) in subgroup with mRS ≥ 3. At baseline VEGF-1 concentration in entire patient cohort was 348.55 pg/mL (IQR=241.70-493.80 pg/mL). We found higher VEGF-1 level in mRS ≥ 3 vs mRS ≤ 2 population sub-groups (P<0.05). Using multivariate Cox regression analysis we reported that VEGF-1 (increased per 125 pg / mL) and type two diabetes mellitus (present versus absent) were found as independent predictors for favorable neurologic recovery. Conclusion: In Conclusion, We found that VEGF-1 (increased per 125 pg / mL) measured at baseline positively predicts improved neurologic recovery at six month among subjects with acute ischemic stroke who were not enrolled for invasive or thrombolytic strategy. Type two diabetes mellitus (present versus absent) were found as independent predictor for favorable neurologic recovery in follow up period.