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Heart. 2019 Apr;105(7):553-558. doi: 10.1136/heartjnl-2018-313684. Epub 2018 Oct 16.

Increased vascular endothelial growth factor D is associated with atrial fibrillation and ischaemic stroke.

Author information

1
Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden.
2
Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden.
3
Department of Heart Failure and Valvular Disease, Skåne University Hospital, Lund, Sweden.
4
Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA.
5
Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Malmö, Sweden.

Abstract

OBJECTIVE:

Vascular endothelial growth factor D (VEGF-D) has important functions in lymphangiogenesis and angiogenesis. High plasma levels of VEGF-D have been associated with incidence of heart failure. The association of VEGF-D with atrial fibrillation (AF) and stroke is unclear and we hypothesised that VEGF-D could also be associated with incidence of AF and ischaemic stroke.

METHODS:

VEGF-D was measured in fasting blood samples of 4689 subjects (40% men) without a history of AF from the Malmö Diet and Cancer Study, a prospective, population-based study in Sweden. Median age was 58 years (range 46-68). Cox regression analyses, adjusted for multiple risk factors, was used to assess AF and ischaemic stroke risk in relation to VEGF-D levels.

RESULTS:

During a median follow-up time of 20.6 years, there were 637 cases of incident AF and 322 cases of first ischaemic stroke. After adjustment, VEGF-D was significantly associated with AF (HR 1.13(95% CI 1.04 to 1.23) per 1 SD increase) and ischaemic stroke (HR 1.14(95% CI 1.02 to 1.28) per 1 SD). The association with ischaemic stroke was explained by an increased incidence of AF-related stroke. HRs per 1 SD were 1.34 (95% CI 1.04 to 1.71) for AF-related ischaemic stroke and 1.04 (95% CI 0.90 to 1.19) for ischaemic stroke without AF.

CONCLUSIONS:

Increased VEGF-D concentrations were associated with AF and ischaemic stroke. The relationship with ischaemic stroke was more pronounced in subjects with a diagnosis of AF.

KEYWORDS:

atrial fibrillation; epidemiology; stroke

PMID:
30327392
DOI:
10.1136/heartjnl-2018-313684
[Indexed for MEDLINE]

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