Supplemental Tables Hepatocyte Growth Factor is Positively Associated with Risk of Stroke : The Multi-Ethnic Study of Atherosclerosis ( MESA )

The protein hepatocyte growth factor (HGF) and its receptor c-Met are produced in response to tissue injury and are functional in tissue repair mechanisms. Their favorable effects in the heart and vasculature include anti-inflammatory, antifibrotic, and proangiogenic actions. Because HGF is released in response to endothelial injury, higher levels of circulating HGF are associated with hypertension, diabetes mellitus, smoking, increased age, body mass index (BMI), and presence and severity of atherosclerotic disease in both the heart and the lower extremities. Despite evidence of a relation of circulating HGF with ischemic and hemorrhagic stroke risk factors, understanding the connection between HGF and stroke is in its infancy. Although previous studies indicate a positive relation between circulating HGF and both ischemic stroke and prognostic factors for the development of stroke, they are limited in that they were conducted in select populations that may not generalize. In addition, only one of these studies measured HGF before stroke, which is important to establish temporality. Finally, the associations of HGF with hemorrhagic stroke and all strokes (hemorrhagic and ischemic combined) have not been reported. Therefore, we sought to examine the relation between circulating HGF and incident stroke using data from a large, multiethnic, population-based prospective cohort study: the MESA (MultiEthnic Study of Atherosclerosis). We hypothesized that circulating HGF would be positively associated with an increased risk of incident stroke. As a secondary analysis, we explored whether there were differences in the association with HGF by stroke type.