Association of high serum levels of growth factors with good outcome in ischemic stroke: A multicenter study

Abstract

Themain objective of this researchwork was to study the association of serumlevels of growth factors (GF) and SDF-1α with the functional outcome and reduction of lesion volume in ischemic stroke patients. In this multicenter study, 552 patients with nonlacunar stroke (male, 62.1%; mean age, 68.2 ± 11.4) were included within 24 h from symptom onset. The main outcome variable was good functional outcome (modified Rankin Scale [mRS] ≤ 2) at 12 months. Secondary outcome variable was infarct volume (inmL) after 6 ± 3 months. Serum levels of VEGF, Ang-1,G-CSF, BDNF, and SDF-1α were measured by ELISA at admission, 7 ± 1 days, at 3 ± 1 months, and 12 ± 3 months. Except for BDNF, all GF and SDF-1α serum levels showed a peak value at day 7 and remained elevated during the first 3 months (all p < 0.01).High serumlevels at day 7 ofVEGF (OR, 19.3),Ang-1 (OR, 14.7), G-CSF (OR, 9.6), and SDF-1α (OR, 28.5) were independently associated with good outcome at 12 months (all p < 0.0001).On the other hand, serum levels of VEGF (B, − 21.4), G-CSF (B, − 14.0), Ang-1 (B, − 13.3), and SDF-1α (B, − 44.6) measured at day 7 were independently associated with lesion volume at 6 months (p < 0.01). In summary, high serum levels of VEGF, Ang-1, G-CSF, and SDF-1α at day 7 and 3 months after ischemic stroke are associated with good functional outcome and smallerresidual lesion at 1 year of follow-up. ; This project was partially supported by grants from the Spanish Ministry of Economy and Competitiveness (SAF2014-56336-R; RTI2018-102165-B-I00 and SAF2017-84267-R), Xunta de Galicia (Consellería Educación: GRC2014/027 and IN607A2018/3), Instituto de Salud Carlos III (PI13/00292, PI14/01879 and PI17/01103), Spanish Research Network on Cerebrovascular Diseases RETICS-INVICTUS PLUS (RD16/0019), and by the European Union FEDER program. T. Sobrino (CP12/03121 &CPII17/00027) and F. Campos (CP14/00154 & CPII19/ 00020) are recipients of research contracts from Miguel Servet Program of Instituto de Salud Carlos III.