High plasma fibroblast growth factor 19 is associated with improved prognosis in patients with acute ischemic stroke

Abstract

Objective

To prospectively investigate the relationships between plasma fibroblast growth factor 19 (FGF-19) and clinical outcomes in patients with acute ischemic stroke.

Methods

Plasma FGF-19 levels at baseline were measured for 3048 patients with ischemic stroke, and all patients were followed up at one year after stroke onset. The primary outcome was a combination of death and major disability (modified Rankin Scale score of ≥3) at one year after stroke onset, and secondary outcomes included major disability, death, recurrent stroke, vascular events and the combination of death and vascular events.

Results

During the 1-year of follow-up, 682 (22.38 %) patients experienced the primary outcome; 503 had a major disability and 179 died. After multivariate adjustment, higher plasma FGF-19 was significantly associated with decreased risk of the primary outcome (odds ratio = 0.48, 95 % confidence interval = 0.36–0.66). Each 1-SD increase of log-transformed FGF-19 (0.93 pg/mL) was associated with 20 % decreased risk of the primary outcome. The addition of FGF-19 to the conventional risk factors significantly improved prediction of the primary outcome in ischemic stroke patients (net reclassification index = 25.10 %, p < 0.001; integrated discrimination improvement = 1.25 %, p < 0.001). Furthermore, patients with both high FGF-19 (≥573.7 pg/mL) and low FGF-21 (<740.1 pg/mL) levels had the lowest incidences of all study outcomes.

Conclusions

High plasma FGF-19 levels were associated with improved prognosis in patients with acute ischemic stroke, suggesting that FGF-19 may be a potential biomarker of good prognosis for ischemic stroke.