Cardiovascular Diabetology (Oct 2023)

Prognostic significance of plasma SDF-1 in acute ischemic stroke patients with diabetes mellitus: the CATIS trial

  • Shoujiang You,
  • Hongyu Chen,
  • Mengyuan Miao,
  • Jigang Du,
  • Bizhong Che,
  • Tan Xu,
  • Chun-Feng Liu,
  • Yonghong Zhang,
  • Jiang He,
  • Xiaoyan Zhong,
  • Yongjun Cao,
  • Chongke Zhong

DOI
https://doi.org/10.1186/s12933-023-01996-0
Journal volume & issue
Vol. 22, no. 1
pp. 1 – 10

Abstract

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Abstract Background and objectives Evidence on the associations between baseline stromal cell-derived factor (SDF)-1 and clinical outcomes in acute ischemic stroke patients is lacking. The present study aimed to examine the relationship between plasma SDF-1 levels and clinical outcomes based on a large multicenter study of the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS). Methods Secondary analysis was conducted among 3,255 participants from the CATIS trial with a baseline measurement of plasma SDF-1 levels. We evaluated the associations between plasma SDF-1 levels and one-year recurrent stroke, cardiovascular events, and all-cause mortality using Cox regression models. We further investigated the prognostic effect of SDF-1 on clinical outcomes in patients with different characteristics. Results Higher plasma SDF-1 levels were not associated with recurrent stroke, cardiovascular events, and all-cause mortality at one-year after ischemic stroke (all P trend ≥ 0.05). There were significant interactions between plasma SDF-1 levels and history of diabetes mellitus on recurrent stroke (P = 0.005), cardiovascular events (P = 0.007) and all-cause mortality (P = 0.04) at one year. In patients with diabetes mellitus, plasma SDF-1 was significantly associated with an increased risk of recurrent stroke and cardiovascular events after adjustment for confounders. For example, 1-SD higher log–SDF-1 was associated with a hazard ratio (95% confidence interval) of 1.65 (1.18–2.32) for recurrent stroke and 1.47 (1.08–1.99) for the cardiovascular events, but not all-cause mortality 1.36 (0.96–1.93) at one year. However, there were no associations between plasma SDF-1 and clinical outcomes in patients without diabetes mellitus (all P > 0.05). The addition of plasma SDF-1 to the conventional risk factors model significantly improved the risk prediction of all outcomes. Similarly, findings between elevated SDF-1 levels and two-year outcomes were found only in patients with diabetes mellitus. Conclusions Elevated plasma SDF-1 was significantly associated with an increased risk of recurrent stroke and cardiovascular events only in ischemic patients with diabetes mellitus.

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