High Serum Levels of Growth Factors Are Associated with Good Outcome in Intracerebral Hemorrhage

Abstract

In experimental models, growth factors (GFs) such as vascular endothelial growth factor (VEGF), Angiopoietin 1 (Ang-1), or granulocyte-colony stimulating factor (G-CSF) mediate brain recovery after intracerebral hemorrhage (ICH). Our aim was to study the association between serum levels of GF and clinical outcome in patients with ICH. A total of 95 patients with primary ICH (male, 66.3%; mean age, 67.8+/-9.8 years) were prospectively included in the study within 12 h from symptoms onset. The main outcome variable was good functional outcome at 3 months (modified Rankin scale < or =2). Median serum levels of GF at 72 h from stroke onset were significantly higher in patients with good outcome (n=39) compared with those with poor outcome (all P<0.0001). Serum levels of VEGF > or =330 pg/mL, G-CSF > or =413 pg/mL, and Ang-1 > or =35 ng/mL at 72 h were independently associated with good functional outcome (odds ratio (OR), 11.2; 95% confidence interval (CI): 2.9 to 43.0; OR, 19.6; 95% CI: 3.9 to 97.9; and OR, 14.7; 95% CI: 3.6 to 60.0, respectively), neurologic improvement (all P<0.0001) and reduced residual cavity at 3 months (all P<0.01). These results illustrate that high serum levels of GF are associated with good functional outcome and reduced lesion volume in ICH.