Abstract
BackgroundThe role of vascular endothelial growth factor (VEGF) in patients in the stable phase after myocardial infarction (MI) has not yet been explored. Therefore, we compared the values of VEGF in post-MI patients with those obtained in healthy controls. Furthermore, we investigated whether the values of VEGF correlate to either inflammation markers or the atherosclerotic burden.Methods41 male patients (on average 44 years old) in the stable phase after MI (on average 20.5 months after MI) were recruited, while 25 healthy age-matched males served as controls. Plasma levels of VEGF and several markers of inflammation were measured by standard procedures. The atherosclerotic burden was determined by the angiographic severity of coronary atherosclerosis, endothelial dysfunction (measured by ultrasound measurement of the flow mediated dilation of the brachial artery), the intima-media thickness of the common carotid artery and the ankle-brachial pressure index.ResultsVEGF values were significantly elevated in post-MI patients compared to the controls (53.8 ± 42.7 pg/ml vs. 36.3 ± 8.9 pg/ml, p = 0.014). The elevated VEGF values significantly correlated to the (increased) values of the inflammatory molecules interleukin 6 and 8 (r = 0.37, p = 0.017; and r = 0.45, p = 0.003; respectively). In contrast, no correlation was found between VEGF and the parameters of the atherosclerotic burden, although FMD and IMT were significantly impaired in patients.ConclusionsWe found that plasma levels of VEGF are increased in the stable phase after MI and correlate with inflammation cytokines, but not with the atherosclerotic burden. Thus, this suggests that increased levels of VEGF are a part of ongoing inflammatory activity. Since VEGF in these patients stimulates neovascularization of inflamed plaques and induces their destabilization, the VEGF level can have an important negative prognostic value. Clearly, further studies are needed to clarify the role of VEGF as a prognostic marker.
Highlights
The role of vascular endothelial growth factor (VEGF) in patients in the stable phase after myocardial infarction (MI) has not yet been explored
We found that VEGF was increased in post-MI patients and that VEGF values correlated with inflammatory cytokines (IL-6 and IL-8), but not with parameters associated with the extent of the atherosclerotic burden
These results suggest that VEGF in the stable phase after MI is a part of the inflammatory response and very likely contributes to worsening of atherosclerosis by inducing plaque instability
Summary
The role of vascular endothelial growth factor (VEGF) in patients in the stable phase after myocardial infarction (MI) has not yet been explored. There is only scare and conflicting data about the role of VEGF in coronary artery disease. In complete contrast, a European study showed that high VEGF levels in the acute phase of MI are related to an adverse outcome during a 6 months follow-up [11]. Discussing these conflicting results one could only conclude that VEGF may have an important prognostic value, but one which surprisingly may be positive or negative. From the clinical point of view it is even more important to investigate the role of VEGF in the stable phase of the disease
Published Version (Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have