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

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

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.

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.

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.