Association of High Serum Levels of Growth Factors with Good Outcome in Ischemic Stroke: a Multicenter Study

Abstract

The main objective of this research work was to study the association of serum levels of growth factors (GF) and SDF-1alpha with the functional outcome and reduction of lesion volume in ischemic stroke patients. In this multicenter study, 552 patients with non-lacunar 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 (in mL) after 6 +/- 3 months. Serum levels of VEGF, Ang-1, G-CSF, BDNF, and SDF-1alpha were measured by ELISA at admission, 7 +/- 1 days, at 3 +/- 1 months, and 12 +/- 3 months. Except for BDNF, all GF and SDF-1alpha serum levels showed a peak value at day 7 and remained elevated during the first 3 months (all p < 0.01). High serum levels at day 7 of VEGF (OR, 19.3), Ang-1 (OR, 14.7), G-CSF (OR, 9.6), and SDF-1alpha (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-1alpha (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-1alpha at day 7 and 3 months after ischemic stroke are associated with good functional outcome and smaller residual lesion at 1 year of follow-up.