Journal
EUROPEAN JOURNAL OF NEUROLOGY
Volume 28, Issue 3, Pages 844-851Publisher
WILEY
DOI: 10.1111/ene.14683
Keywords
fibroblast growth factor 21; ischemic stroke; prognosis
Categories
Funding
- National Key Research and Development Program of China [2016YFC1307300, 81673263]
- National Natural Science Foundation of China
- Priority Academic Program Development of Jiangsu Higher Education Institutions, China
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Elevated plasma fibroblast growth factor 21 (FGF-21) levels were found to be associated with poor prognosis in patients with acute ischemic stroke, increasing the risk of death or major disability. Using FGF-21 as a prognostic marker may help evaluate the prognosis of stroke patients.
Background and purpose To evaluate the association between plasma fibroblast growth factor 21 (FGF-21) and clinical outcomes in patients with acute ischemic stroke. Methods A total of 3412 acute ischemic stroke patients from the China Antihypertensive Trial in Acute Ischemic Stroke with plasma FGF-21 measurements were included in this analysis. The primary outcome was a combination of death or major disability (modified Rankin Scale score >= 3) within 1 year after stroke. Results During the 1-year of follow-up, 745 (21.83%) patients experienced the primary outcome; 550 had a major disability and 195 died. After multivariate adjustment, higher plasma FGF-21 was significantly associated with increased risk of the primary outcome (odds ratio = 1.52, 95% confidence interval = 1.11-1.29). Each 1-SD increase of log-transformed FGF-21 (0.67 pg/ml) was associated with 19%, 3%, and 33% increased risk of the primary outcome, major disability, and death, respectively. The addition of FGF-21 to the conventional risk factors significantly improved prediction of the primary outcome in ischemic stroke patients (net reclassification index = 10.8%, p = 0.011; integrated discrimination improvement = 0.3%, p = 0.038). Conclusions Higher plasma FGF-21 was associated with poor prognosis in acute ischemic stroke patients, suggesting that FGF-21 may be a prognostic marker for ischemic stroke.
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