Prognostic value of growth differentiation factor-15 3 months after an acute chest pain admission.
Heart
; 110(7): 508-516, 2024 Mar 12.
Article
em En
| MEDLINE
| ID: mdl-38000899
ABSTRACT
OBJECTIVE:
Growth differentiation factor-15 (GDF-15) is a predictor of death and cardiovascular events when measured during index hospitalisation in patients with acute chest pain. This study investigated the prognostic utility of measuring GDF-15 3 months after an admission with suspected non-ST-elevation acute coronary syndrome (NSTE-ACS).METHODS:
GDF-15 was measured at baseline and 3 months after admission in 758 patients admitted with suspected NSTE-ACS. Patients were followed for a median of 1540 (IQR 1087-1776) days after the 3-month visit. The primary endpoint was all-cause mortality, while the secondary composite endpoint included all-cause mortality, incident myocardial infarction and heart failure hospitalisation during follow-up.RESULTS:
In patients with GDF-15 ≥1200 pg/mL (n=248), 18% died and 25% met the composite endpoint. In patients with GDF-15 <1200 pg/mL (n=510), 1.7% died and 4% met the composite endpoint. The GDF-15 concentration (log2 transformed) at 3 months was significantly associated with all-cause mortality (adjusted HR 2.2, 95% CI 1.4 to 3.3, p<0.001) and the composite endpoint (adjusted HR 1.9, 95% CI 1.4 to 2.7, p<0.001), independently of traditional risk factors and baseline troponin T. A 10% change in GDF-15 concentration from baseline to the 3-month visit was associated with increased risk of all-cause mortality (HR 1.06, 95% CI 1.01 to 1.13, p=0.031), adjusting for baseline GDF-15 concentrations.CONCLUSIONS:
High GDF-15 concentrations 3 months after admission for suspected NSTE-ACS are associated with long-term mortality and cardiovascular events, independent of traditional risk factors and troponin T. A change in GDF-15 concentration can provide prognostic information.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Síndrome Coronariana Aguda
/
Infarto do Miocárdio
Limite:
Humans
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article