Heterogeneity of VEGF dynamics in the acute period of ischemic stroke: association with disease severity and short-term outcomes

Aim. To evaluate serum vascular endothelial growth factor (VEGF) levels in the dynamics of the acute period of ischemic stroke in patients during clinical and functional recovery.
Material and methods. The study included 114 patients with ischemic stroke. Patient groups were the following: Group 1 – mild stroke (n = 57 patients), Group 2 – moderate stroke (n = 25 patients), Group 3 – severe stroke (n = 32 patients). Observation period was 14 days. Observation points included: I – the first 48–72 hours from the onset of the disease; II – the 14th day. We used the following assessment scales National Institute of Health Stroke Scale (NIHSS) and the modified Rankin Scale (mRS). VEGF was determined in blood serum on a multiplex analyzer. Statistical processing of the results was carried out using the Statistica 13.0 software package.
Results. Patients of groups 1 and 2 showed a statistically significant decrease in points on the NIHSS and mRs scales (p < 0.001) in the dynamics of observation, in patients of group 3 no significant changes were found (p = 0.157 and p = 0.315, respectively). VEGF in the comparison group did not show reliable differences relative to patients at points I (pz–1 = 0.73, pz–2 = 0.738, pz–3 = 0.129) and II of observation (pz–1 = 0.66, pz–2 = 0.817, pz–3 = 0.276). Analysis of the dynamics of the marker revealed an increase in VEGF between points I and II of observation in group 3 (p = 0.021), ΔVEGF positively correlated with a higher score on the NIHSS scale at point I (r = 0.691; p = 0.027). No correlation relationships were found in group 1 (рI–II = 0.078, r∆VEGF-NIHSS_I = –0.294; р∆VEGF-NIHSS_I = 0.237) and group 2 patients (рI–II = 0.285, r∆VEGF-NIHSS_I = –0.305; р∆VEGF-NIHSS_I = 0.392).
Conclusion. Heterogeneity of ischemic stroke pathogenesis reduces the prognostic value of VEGF as an isolated biomarker. A comprehensive analysis of the temporal patterns of VEGF regulation and other angiogenic factors is needed to understand the dynamics of vascular remodeling and predict the outcomes of ischemic stroke.

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