Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Jiangsu, China.
Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA.
Eur J Neurol. 2021 Mar;28(3):844-851. doi: 10.1111/ene.14683. Epub 2021 Jan 5.
To evaluate the association between plasma fibroblast growth factor 21 (FGF-21) and clinical outcomes in patients with acute ischemic stroke.
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.
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).
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.
评估血浆成纤维细胞生长因子 21（FGF-21）与急性缺血性脑卒中患者临床结局的相关性。
本分析共纳入了 3412 例来自中国急性缺血性脑卒中降压试验（CATIS）且测量了血浆 FGF-21 的急性缺血性脑卒中患者。主要结局为卒中后 1 年内死亡或重度残疾（改良 Rankin 量表评分≥3）的联合终点。
在 1 年的随访期间，745 例（21.83%）患者发生了主要结局事件；550 例发生了重度残疾，195 例死亡。经多变量调整后，较高的血浆 FGF-21 与主要结局风险增加显著相关（比值比=1.52，95%置信区间：1.11-1.29）。每增加 1-SD 的对数转化 FGF-21（0.67 pg/ml），主要结局、重度残疾和死亡的风险分别增加 19%、3%和 33%。将 FGF-21 添加到常规危险因素中可显著改善缺血性脑卒中患者主要结局的预测（净重新分类指数=10.8%，p=0.011；综合判别改善=0.3%，p=0.038）。
较高的血浆 FGF-21 与急性缺血性脑卒中患者的不良预后相关，提示 FGF-21 可能是缺血性脑卒中的预后标志物。
