Elevated FGF23 levels predict cardiovascular and cerebrovascular events in acute ischaemic stroke patients

BACKGROUNDThere have been recent studies on fibroblast growth factor 23 (FGF23) and acute ischaemic stroke (AIS), but some of the results were conflicting. Therefore, the objective of this study was to assess whether baseline FGF23 was associated with the occurrence of major adverse cardiovascular and cerebrovascular events (MACCE) in AIS patients. METHODSThis study enrolled 394 patients with AIS and followed for a median period of 43 months. 130 people who underwent health check-ups in our hospital were selected as the control group. The study endpoint was the first occurrence of MACCE outside the hospital. Serum FGF23 levels were quantified using an enzyme-linked immunosorbent assay. RESULTSSerum FGF23 levels were found to be significantly higher in the AIS group than in the control group (525.14{+/-}167.40 vs 338.62{+/-}161.71, P<0.05). Furthermore, serum FGF23 levels were observed to be elevated in the MACCE group in comparison to the no MACCE group (646.09{+/-}164.05 vs 491.87{+/-}152.54, P<0.05). According to the receiver operating characteristic curve analysis, the predictive value of the combination of the three [FGF23, National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS)] for the occurrence of MACCE in AIS was higher than that of any of them (P<0.05), while the difference between the three was not statistically significant. The cumulative MACCE-free survival was found to be significantly higher in the group with low FGF23 levels than in the group with high FGF23 levels, as demonstrated by Kaplan-Meier analysis (P<0.05). The multifactorial Cox analysis revealed that the elevated baseline serum FGF23 level (HR: 3.731, 95% CI: 2.157-6.452) was a significant predictor of MACCE in AIS patients. CONCLUSIONSElevated baseline serum FGF23 levels were considered to be a valid predictor of MACCE in patients with AIS.