Predictive value of circulating inflammatory biomarkers in hypertensive patients after acute ischemic stroke
Резюме. Objective. The aim of the study was to investigate the predictive value of inflammatory biomarkers in hypertensive patients after acute ischemic stroke. Methods. 102 patients with mild to moderate arterial hypertension within 3 weeks after ischemic stroke were included in the study with follow-up observation during 12 months with 3 month intervals. The circulating level of vascular endothelial growth factor-1 (VEGF-1), metalloproteinase-9 (MMP-9), and high sensitive C-reactive protein (hs-CRP) was assessed at baseline. Clinical interviews had been conducted every 3 months for 1 year after receiving blood samples. All recurrent cardiovascular outcomes were determined as end points. Results. Analysis of obtained outcomes have been shown that circulating levels of VEGF-1 over 403.57 pg/mL (Odds Ratio [OR]=2.78, 95% confidence interval [CI]=2.4–2.95; Wald test=6.515; Р=0.011) appears to be the most significant prognostic value for cumulative clinical events (CCE). However, circulating levels of MMP-9 (OR=2.61; 95% CI=2.37–3.16; Wald test=7.32; Р=0.001), diabetes mellitus, type 2 (OR=2.11; 95% CI=1.47–2.59; Wald test=3.52; Р=0.001), hs-CRP (OR=1.62; Wald test=5,784; Р=0,003), and male sex (OR=1.25; Wald test=1.885; Р=0.012) were also determined as clinically significant predictors for CCE after acute ischemic stroke. Сonclusions. Using reclassification methods, however, we found that addition of both biomarkers combination (hs-СRР + MMP-9) to the ABC model (VEGF-1) improved the relative IDI for CCE by 9.3%. In conclusion, we found that combination of three inflammatory circulating biomarkers (VEGF-1, hs-СRР, MMP-9) in hypertensive patients after ischemic stroke represent the best one-year predictive values for cardiovascular recurrent events risk, when compared to either of biomarker alone.