Abstract WP152: The Predictive Value of VEGF And SDF-1α For The Functional Outcome In Patients with Acute Lacunar Infarction Superimposed on Silent Brain Infarction
Introduction : Stroke is one of the most common causes of chronic disability and death. Although prediction of stroke outcome is important, outcome predictors still remain unclear. Vascular endothelial growth factor (VEGF), stromal cell-derived factor-1α (SDF-1α), macrophage migration inhibitory factor (MIF), and high mobility group box 1 (HMGB1) have been reported to play critical roles in neurovascular remodeling or mediating inflammation at acute and subacute phase after ischemic stroke.
Hypothesis : Wehypothesized that association between silent infarctions and favorable outcome would be affected by expression of angiogenic factors.
Methods : From January 2009 to March 2011, 68 consecutive patients with first-ever lacunar infarction (50%) intracranial and extracranial stenosis, use of rtPA and strokes of other determined etiologies. We also excluded patients with acute infection, chronic inflammatory disease and cancers. Serum samples were collected from patients immediately after admission and were stored at -80°C. Serum VEGF, SDF-1α, MIF, and HMGB1 were assessed with commercially available quantitative sandwich ELISA kit. Clinical, laboratory, and image findings including NIH stroke scale were obtained at admission and modified Rankin Scale (mRS) was evaluated after 3 months of stroke onset. A favorable outcome was defined as an mRS between 0 to 1.
Result : Silent brain infarctions were noted in 31 (45%) of the 68 patients. Patients with silent infarctions were associated with hypertension (p=0.055) and advanced leukoaraiosis (p<0.001).
Conclusions : In patients with lacunar infarction, previous silent infarctions were associated with favorable outcome and early increased expression of VEGF. We suggest that association between silent infarctions and favorable outcome may be affected by expression of angiogenic factors such as VEGF. On the other hand, the finding that SDF-1α reflecting the severity of lacunar infarctions decreased in acute lacunar infarction patients with silent infarctions might suggest that lesser SDF-1α may be related with lesser damage after acute lacunar infarction and then better outcome.
- © 2012 by American Heart Association, Inc.