Abstract
Background Although the level of serum vascular endothelial growth factor (VEGF) is elevated in coronary artery disease (CAD) patients, its potential role in acute coronary syndrome (ACS) or stable angina pectoris (SAP) patients remains unclear. Objectives To evaluate diagnostic accuracy of serum VEGF in determining ACS patients from SAP and analyze the association of serum VEGF with coronary artery lesions in SAP or the GRACE score in ACS, which is involved in the poor prognosis of low serum VEGF. Methods 248 CAD patients and 48 healthy subjects were enrolled in this study. Serum VEGF levels were detected by using ELISA. The Gensini score or GRACE score was calculated among SAP or ACS patients. All the patients were followed up for a period of 12 months (mean: 10.77 months). Results VEGF serum concentrations were higher in the ACS subgroup than in the SAP subgroup (P < 0.001) with diagnostic accuracy of ACS from SAP (AUC: 0.667, sensitivity: 68.5%, specificity: 60.1%, P < 0.001). Patients with high risk of Gensini score showed reduced VEGF levels (P < 0.001) accompanied by a negative correlation (r = −0.396, P < 0.001). Patients with a higher GRACE score indicated lower VEGF levels (P < 0.001). Low serum VEGF was one of the potential risk factors with adjusted HR of 0.531 (P=0.048). Conclusion Serum VEGF exhibits efficient diagnostic value for detection of ACS from SAP with a cutoff value of 648.75 pg/mL. Low serum VEGF indicates severe coronary artery lesions and a higher GRACE score, which suggests poor clinical outcomes.
Highlights
Coronary artery disease (CAD), emerged mainly as cardiovascular disease, caused almost 8 × 106 deaths per year with an increase of 47.5% from 1990 to 2013 around the world [1]. e estimated costs for the treatment of coronary artery disease (CAD) and myocardial infarction (MI) were 12.1 and 9 billion, respectively, in 2013 and will increase by as much as 100% in 20 years [2]
Serum vascular endothelial growth factor (VEGF) levels were detected by using enzyme-linked immunosorbent assay (ELISA). e Gensini score or GRACE score was calculated among stable angina pectoris (SAP) or acute coronary syndrome (ACS) patients
CAD was characterized as the vicinity of luminal width narrowing of 50% in the left anterior descending artery (LAD), left circumflex (LCX), or right coronary artery (RCA). e diagnostic criteria of CAD were in accordance with the relevant guidelines by two experienced cardiologists [8]
Summary
The level of serum vascular endothelial growth factor (VEGF) is elevated in coronary artery disease (CAD) patients, its potential role in acute coronary syndrome (ACS) or stable angina pectoris (SAP) patients remains unclear. To evaluate diagnostic accuracy of serum VEGF in determining ACS patients from SAP and analyze the association of serum VEGF with coronary artery lesions in SAP or the GRACE score in ACS, which is involved in the poor prognosis of low serum VEGF. E Gensini score or GRACE score was calculated among SAP or ACS patients. Patients with high risk of Gensini score showed reduced VEGF levels (P < 0.001) accompanied by a negative correlation (r − 0.396, P < 0.001). Patients with a higher GRACE score indicated lower VEGF levels (P < 0.001). Serum VEGF exhibits efficient diagnostic value for detection of ACS from SAP with a cutoff value of 648.75 pg/mL. Low serum VEGF indicates severe coronary artery lesions and a higher GRACE score, which suggests poor clinical outcomes
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