Promising Role of Vascular Endothelial Growth Factor-A in Risk Stratification after PCI

Abstract

Vascular endothelial growth factor-A (VEGF-A), dimeric glycoprotein, is a potent endothelial cell-specific mitogen which plays a key role in angiogenesis, espe-cially in response to ischemia. Biomarkers reflect various pathophysiological faces of spherical LV transformation that related to myocardial stress due to persisted ischemia, fibrosis, and inflammation, and they may be helpful to improve risk stratification, more personalized medical approach for creating of individual medical care for HF preventing and adjusted treatment after STEMI. VEGF-A decrease ≤ 172.4 pg./ ml on the 7th day of STEMI allows to prognose after infarction angina after 6-month observation (area under curve (AUC) 0.697, with sensitivity 88.9% and specificity 50.9%; 95% CI 0.567–0.807, P = 0.0515). Anxiety and depression 10–14 days before MI associated with VEGF-A level decrease (anxiety (Taylor): OR 0.834, 95% C І 0.726–0.959, Р = 0.0107; depression (HADS): OR 0.741, 95% C І 0.535–1.027, Р = 0.0519. Cut-off VEGF-A level ≤ 201.86 pg./ml on the 7th day of STEMI (AUC 0.711, sensitivity 85.7% and specificity 57.9%; 95% C І 0.513–0.908, Р = 0.036) was effective for prognosis of dysadaptive left ventricular remodeling in STEMI patients after 6-month observation period. These findings may open new approach to stratify patients with successful coronary revascularization at risk of HF.