Growth Differentiation Factor 15: A Prognostic Marker in Patients with Acute Chest Pain without Acute Myocardial Infarction.
Clin Chem
; 69(6): 649-660, 2023 06 01.
Article
em En
| MEDLINE
| ID: mdl-36994764
ABSTRACT
BACKGROUND:
Acute chest pain is associated with an increased risk of death and cardiovascular events even when acute myocardial infarction (AMI) has been excluded. Growth differentiation factor-15 (GDF-15) is a strong prognostic marker in patients with acute chest pain and AMI, but the prognostic value in patients without AMI is uncertain. This study sought to investigate the ability of GDF-15 to predict long-term prognosis in patients presenting with acute chest pain without AMI.METHODS:
In total, 1320 patients admitted with acute chest pain without AMI were followed for a median of 1523 days (range 4 to 2208 days). The primary end point was all-cause mortality. Secondary end points included cardiovascular (CV) death, future AMI, heart failure hospitalization, and new-onset atrial fibrillation (AF).RESULTS:
Higher concentrations of GDF-15 were associated with increased risk of death from all causes (median concentration in non-survivors vs survivors 2124 pg/mL vs 852 pg/mL, P < 0.001), and all secondary end points. By multivariable Cox regression, GDF-15 concentration ≥4th quartile (compared to <4th quartile) remained an independent predictor of all-cause death (adjusted hazard ratio (HR) 2.75; 95% CI, 1.69-4.45, P < 0.001), CV death (adjusted HR 3.74; 95% CI, 1.31-10.63, P = 0.013), and heart failure hospitalization (adjusted HR 2.60; 95% CI, 1.11-6.06, P = 0.027). Adding GDF-15 to a model consisting of established risk factors and high-sensitivity cardiac troponin T (hs-cTnT) led to a significant increase in C-statistics for prediction of all-cause mortality.CONCLUSIONS:
Higher concentrations of GDF-15 were associated with increased risk of mortality from all causes and risk of future CV events.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Insuficiência Cardíaca
/
Infarto do Miocárdio
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Clin Chem
Assunto da revista:
QUIMICA CLINICA
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Noruega