title: Stable phase post-MI patients have elevated VEGF levels correlated with inflammation markers, but not with atherosclerotic burden.
abstract: BACKGROUND
  The 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.
  
  
  METHODS
  41 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.
  
  
  RESULTS
  VEGF 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.
  
  
  CONCLUSIONS
  We 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.
authors.affiliation: Department of Vascular Disease, University Clinical Centre, Ljubljana 1000, Slovenia. erzen_b@yahoo.com.
authors.forename: Barbara
authors.initials: B
authors.lastname: ErŽen
authors.forename: Mira
authors.initials: M
authors.lastname: Šilar
authors.forename: Mišo
authors.initials: M
authors.lastname: Šabovič
mesh_terms: D000328:Adult; D055109:Ankle Brachial Index; D050197:Atherosclerosis / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D002340:Carotid Artery Diseases / Q000097:blood* / Q000175:diagnosis; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000175:diagnosis; D003430:Cross-Sectional Studies; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis; D011237:Predictive Value of Tests; D011379:Prognosis; D012720:Severity of Illness Index; D013997:Time Factors; D015854:Up-Regulation; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*; D014664:Vasodilation
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A