Serum vascular endothelial growth factor (VEGF) levels in ischemic stroke patients: a systematic review and meta-analysi
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ORIGINAL ARTICLE
Serum vascular endothelial growth factor (VEGF) levels in ischemic stroke patients: a systematic review and meta-analysis of case–control studies Ali Seidkhani-Nahal 1 & Afra Khosravi 2 & Asad Mirzaei 3,4 & Gholam Basati 1 & Milad Abbasi 5 & Ali Noori-Zadeh 5,6 Received: 16 April 2020 / Accepted: 28 August 2020 # Fondazione Società Italiana di Neurologia 2020
Abstract Serum VEGF level is regarded to be a biomarker for the diagnosis of stroke. Even though there have been published plethora of original articles describing higher blood VEGF concentrations since the 1970s, however, there is no any meta-analysis report for serum VEGF levels in the field of evidence-based medicine yet. A systematic review was performed by searching the online biomedical databases including retrieving 14 case–control studies including within-article subgroups after fulfilling the inclusion and exclusion criteria without the beginning date restriction, until 2020 for ischemic stroke patients. The Q quantity and I2% statistic index showed a high heterogeneity (84.895 and 84.687, respectively) and the random-effects model of meta-analysis was applied for further analyses. The meta-analysis on a total number of 769 stroke subjects and 621 controls found that the weighted pooled SMD for overall serum VEGF levels on different days of testing was 1.92 (95% CI, − 4.059–0.219, p value = 0.079) and the pooled SMD for overall serum VEGF levels on day 1 of testing was − 1.083 (95% CI, − 4.229–2.063, p value = 0.500). The meta-regression results demonstrated that different days of testing do not significantly affect serum VEGF concentrations in ischemic patients and actually their serum levels are time-independent. Based on the recently published studies, this metaanalysis showed that serum VEGF levels were not significantly associated with an ischemic stroke diagnosis. Thus, researchers may concern another ideal serum or cerebrospinal fluid-derived biomarker for stroke diagnosis. Keywords Serum biomarker . Meta-analysis . VEGF . Ischemic stroke . Hemorrhagic stroke
Introduction Stroke results from a cerebral or precerebral artery occlusion or an intracerebral hemorrhage which leads to focal hypoxia, ischemia or infarction, and necrosis of resident cells of the ischemic strike core [1, 2]. Constituting around 80% of all * Ali Noori-Zadeh [email protected]; [email protected]
strokes, ischemic stroke is the most common type of stroke so far [3, 4], and 60% of ischemic strokes are attributable to large-artery ischemia [5]. According to the World Health Organization, stroke is defined as a rapidly developing focal (or global) brain dysfunction of vascular origin lasting more than 24 h. Thus, it encompasses ischemic stroke, intracerebral 1
Department of Clinical Biochemistry, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
Ali Seidkhani-Nahal [email protected]
2
Department of Clinical Immunology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
Afra Khosravi afrakhosravi@ya
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