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Background Recent studies on fibroblast growth factor 23 (FGF23) and acute ischaemic stroke (AIS) have been conducted, but some of the results are conflicting. Therefore, the objective of this study was to assess whether baseline FGF23 levels are associated with the occurrence of major adverse cardiovascular and cerebrovascular events (MACCEs) in AIS patients. Methods In this study, 394 patients with AIS were enrolled. A total of 130 people who underwent health check-ups in our hospital composed the control group. The study endpoint was the first occurrence of MACCEs outside the hospital. Serum FGF23 levels were measured using a commercial human enzyme-linked immunosorbent assay kit. Results Eighty five MACCEs were recorded during a median follow-up of 43 months. Serum FGF23 levels were found to be significantly greater in the AIS group than in the control group (525.14 ± 167.40 pg./mL vs. 338.62 ± 161.71 pg./mL, p 0.05). Furthermore, the serum FGF23 level was greater in the MACCE group than in the non-MACCE group (646.09 ± 164.05 pg./mL vs. 491.87 ± 152.54 pg./mL, p 0.05). According to the receiver operating characteristic curve analysis, the predictive value of the combination of the three indicators the FGF23 level, National Institutes of Health Stroke Scale (NIHSS) score and modified Rankin scale (mRS) score for the occurrence of MACCEs in AIS patients was greater than that of any of them alone ( p 0.05), while the difference between the three indicators was not statistically significant. The cumulative MACCE-free survival was found to be significantly greater 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 multivariate Cox analysis revealed that the elevated baseline serum FGF23 levels (HR: 3.731, 95% CI: 2.157–6.452) were a significant predictor of MACCEs in AIS patients. Conclusion Elevated baseline serum FGF23 level was considered a valid predictor of MACCEs in patients with AIS.
Chen et al. (Fri,) studied this question.