Increased vascular endothelial growth factor D is associated with atrial fibrillation and ischaemic stroke
Increased vascular endothelial growth factor D is associated with atrial fibrillation and ischaemic stroke
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DOI：
10.1136/heartjnl-2018-313684
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发表时间：
2019-04-01
期刊：
影响因子：
5.7
通讯作者：
Engstrom, Gunnar
中科院分区：
文献类型：
--
作者：
Berntsson, John;Smith, J. Gustav;Engstrom, Gunnar
目的血管内皮生长因子D （VEGF-D）在淋巴管生成和血管生成中具有重要作用。高血浆VEGF-D水平与心力衰竭的发生率有关。VEGF-D与房颤（AF）和脑卒中的关系尚不清楚，我们假设VEGF-D也可能与房颤和缺血性脑卒中的发生率有关。方法：对来自瑞典马尔默饮食和癌症研究（Malmo Diet and Cancer Study）的4689名无房颤史的受试者（40%为男性）的空腹血液样本进行VEGF-D测定。中位年龄为58岁（范围46-68岁）。Cox回归分析，校正多种危险因素，用于评估AF和缺血性卒中风险与VEGF-D水平的关系。结果在20.6年的中位随访期间，发生房颤637例，首次缺血性脑卒中322例。调整后，VEGF-D与房颤（每增加1个SD风险比1.13(95% CI 1.04至1.23)）和缺血性卒中(每增加1个SD风险比1.14（95% CI 1.02至1.28）显著相关。与缺血性卒中的关联可以通过心房颤动相关卒中发生率的增加来解释。房颤相关的缺血性卒中每1个SD的hr为1.34 (95% CI 1.04 - 1.71)，无房颤的缺血性卒中每1个SD的hr为1.04 （95% CI 0.90 - 1.19）。结论VEGF-D浓度升高与房颤和缺血性卒中相关。在诊断为房颤的受试者中，与缺血性卒中的关系更为明显。
Objective Vascular endothelial growth factor D (VEGF-D) has important functions in lymphangiogenesis and angiogenesis. High plasma levels of VEGF-D have been associated with incidence of heart failure. The association of VEGF-D with atrial fibrillation (AF) and stroke is unclear and we hypothesised that VEGF-D could also be associated with incidence of AF and ischaemic stroke.Methods VEGF-D was measured in fasting blood samples of 4689 subjects (40% men) without a history of AF from the Malmo Diet and Cancer Study, a prospective, population-based study in Sweden. Median age was 58 years (range 46-68). Cox regression analyses, adjusted for multiple risk factors, was used to assess AF and ischaemic stroke risk in relation to VEGF-D levels.Results During a median follow-up time of 20.6 years, there were 637 cases of incident AF and 322 cases of first ischaemic stroke. After adjustment, VEGF-D was significantly associated with AF (HR 1.13(95% CI 1.04 to 1.23) per 1 SD increase) and ischaemic stroke (HR 1.14(95% CI 1.02 to 1.28) per 1 SD). The association with ischaemic stroke was explained by an increased incidence of AF-related stroke. HRs per 1 SD were 1.34 (95% CI 1.04 to 1.71) for AF-related ischaemic stroke and 1.04 (95% CI 0.90 to 1.19) for ischaemic stroke without AF.Conclusions Increased VEGF-D concentrations were associated with AF and ischaemic stroke. The relationship with ischaemic stroke was more pronounced in subjects with a diagnosis of AF.