title: Impact of low levels of vascular endothelial growth factor after myocardial infarction on 6-month clinical outcome. Results from the Nagoya Acute Myocardial Infarction Study.
abstract: BACKGROUND
  Vascular endothelial growth factor (VEGF) is induced by myocardial ischemia and is thought to facilitate cardiovascular repair after acute myocardial infarction (AMI). However, the association between the plasma VEGF levels and clinical outcome in AMI patients is unclear.
  
  
  RESULTS
  We evaluated 879 AMI patients undergoing successful primary revascularization within 24h of symptom onset. The patients were classified into 3 groups according to tertiles of plasma VEGF levels at 7 days after the onset of AMI. Major adverse cardiovascular and cerebrovascular events (MACCE), defined as cardiac death, recurrent acute coronary syndrome, hospital readmission for heart failure, or stroke, were assessed during the 6-month follow-up period. The incidence of MACCE was the least frequent in the middle tertile. Compared to the middle tertile, patients in the low tertile were at a significantly higher risk for MACCE even after adjusting for baseline characteristics (hazard ratio [HR] 2.67, 95% confidence interval [CI] 1.18-6.06, P=0.019). An absence of statin treatment before onset and a younger age (HR 0.54, 0.87; 95%CI 0.33-0.90, 0.76-0.99; P=0.017, 0.037; respectively) were significantly associated with low VEGF.
  
  
  CONCLUSIONS
  Low plasma VEGF levels at 7 days after the onset of AMI were associated with a significantly increased risk for MACCE during 6 months of follow-up.
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Matsudaira
authors.forename: Kengo
authors.initials: K
authors.lastname: Maeda
authors.forename: Naoki
authors.initials: N
authors.lastname: Okumura
authors.forename: Daiji
authors.initials: D
authors.lastname: Yoshikawa
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Morita
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Mitsuhashi
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishii
authors.forename: Takahisa
authors.initials: T
authors.lastname: Kondo
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Murohara
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000209:etiology; D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000209:etiology; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000401:mortality / Q000628:therapy*; D009204:Myocardial Revascularization / Q000009:adverse effects / Q000401:mortality; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
chemical_list: D015415:Biomarkers; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A