PT  - JOURNAL ARTICLE
AU  - John Berntsson
AU  - J Gustav Smith
AU  - Linda S B Johnson
AU  - Martin Söderholm
AU  - Yan Borné
AU  - Olle Melander
AU  - Marju Orho-Melander
AU  - Jan Nilsson
AU  - Gunnar Engström
TI  - Increased vascular endothelial growth factor D is associated with atrial fibrillation and ischaemic stroke
AID  - 10.1136/heartjnl-2018-313684
DP  - 2019 Apr 01
TA  - Heart
PG  - 553--558
VI  - 105
IP  - 7
4099  - http://heart.bmj.com/content/105/7/553.short
4100  - http://heart.bmj.com/content/105/7/553.full
SO  - Heart2019 Apr 01; 105
AB  - Objective Vascular endothelial growth factor D (VEGF-D) has important functions in lymphangiogenesis and angiogenesis. High plasma levels of VEGF-D have been associated with incidence of heart failure. The association of VEGF-D with atrial fibrillation (AF) and stroke is unclear and we hypothesised that VEGF-D could also be associated with incidence of AF and ischaemic stroke.Methods VEGF-D was measured in fasting blood samples of 4689 subjects (40% men) without a history of AF from the Malmö Diet and Cancer Study, a prospective, population-based study in Sweden. Median age was 58 years (range 46–68). Cox regression analyses, adjusted for multiple risk factors, was used to assess AF and ischaemic stroke risk in relation to VEGF-D levels.Results During a median follow-up time of 20.6 years, there were 637 cases of incident AF and 322 cases of first ischaemic stroke. After adjustment, VEGF-D was significantly associated with AF (HR 1.13(95% CI 1.04 to 1.23) per 1 SD increase) and ischaemic stroke (HR 1.14(95% CI 1.02 to 1.28) per 1 SD). The association with ischaemic stroke was explained by an increased incidence of AF-related stroke. HRs per 1 SD were 1.34 (95% CI 1.04 to 1.71) for AF-related ischaemic stroke and 1.04 (95% CI 0.90 to 1.19) for ischaemic stroke without AF.Conclusions Increased VEGF-D concentrations were associated with AF and ischaemic stroke. The relationship with ischaemic stroke was more pronounced in subjects with a diagnosis of AF.