Long-term prognostic value of growth differentiation factor-15 in acute coronary syndromes.
Clin Biochem
; 73: 62-69, 2019 Nov.
Article
em En
| MEDLINE
| ID: mdl-31369736
ABSTRACT
BACKGROUND:
Growth Differentiation Factor-15 (GDF-15) predicts death and cardiovascular events in acute coronary syndromes (ACS). We aimed to assess the long-term prognostic value of GDF-15 in ACS.METHODS:
We included 358 patients with ACS who underwent coronary angiography. Plasma GDF-15 was measured and clinical data and long-term events were registered. Incremental value of GDF-15 for prognosing all-cause death above a clinical model including GRACE score, left ventricular ejection fraction <40%, prior myocardial infarction and age was assessed.RESULTS:
GDF-15 concentrations >1800â¯ng/L were associated with an increased prevalence of cardiovascular risk factors. During 6.5â¯years of follow-up 56 patients died, 7 had values of GDF-15â¯<â¯1200â¯ng/L, 7 between 1200 and 1800â¯ng/L and 42â¯>â¯1800â¯ng/L. After adjustment for potential confounders, GDF-15â¯>â¯1800â¯ng/L were independently associated with all-cause death (HR 4.09; 95% CI 1.57-10.71; pâ¯=â¯.004) and the composite of major adverse cardiovascular events (MACE) (HR 2.48; 95% CI 1.41-4.34; pâ¯=â¯.001). For long-term all-cause death a significant increase of ROC curve was seen after addition of GDF-15 to a clinical model 0.876 (95% CI 0.823-0.928; pâ¯=â¯.014). Same improvements were found for net reclassification improvement (0.776; 95% CI 0.494-1.037; pâ¯<â¯.001) and integrated discrimination improvement (0.112; 95% CI 0.055-0.169; pâ¯<â¯.001). Multivariate competing risk model showed a significant association between GDF-15â¯>â¯1800â¯ng/L and the incidence of heart failure but not of myocardial infarction.CONCLUSIONS:
In the setting of ACS, GDF-15 is associated with long-term all-cause death, MACE and heart failure and provides incremental prognostic value beyond traditional risks factor.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Síndrome Coronariana Aguda
/
Fator 15 de Diferenciação de Crescimento
/
Insuficiência Cardíaca
Tipo de estudo:
Observational_studies
/
Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
/
Pregnancy
Idioma:
En
Revista:
Clin Biochem
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Espanha