Growth differentiation factor 15 predicts cardiovascular events in stable coronary artery disease

作     者：Juan WANG Li-Na HAN Dao-Sheng AI Xin-Yu WANG Wan-Jing ZHANG Xiao-Rong XU Hong-Bin LIU Jing ZHANG Pan WANG Xu LI Mu-Lei CHEN Juan WANG;Li-Na HAN;Dao-Sheng AI;Xin-Yu WANG;Wan-Jing ZHANG;Xiao-Rong XU;Hong-Bin LIU;Jing ZHANG;Pan WANG;Xu LI;Mu-Lei CHEN

作者机构：Heart Center of Beijing Chao-Yang HospitalCapital Medical UniversityBeijing Key Laboratory of HypertensionBeijingChina Department of Cardiologythe Second Medical CenterNational Clinical Research Center for Geriatric DiseasesChinese PLA General HospitalBeijingChina Academy for Advanced Interdisciplinary StudiesPeking University National Institute of Biological SciencesZhongguancun Life Science ParkTsinghua UniversityBeijingChina 

出 版 物：《Journal of Geriatric Cardiology》 (老年心脏病学杂志（英文版）)

年 卷 期：2023年第20卷第7期

页      面：527-537页

核心收录：

学科分类：1002[医学-临床医学] 10[医学] 

基　　金：supported by in part by the National Natural Science Fund (81900382) supported,in part,by the Yang Talents Program of Beijing (QML20200302) Beijing Municipal Natural Science Foundation (7222072) 

主　　题：cardiovascular elevated coronary 

摘      要：BACKGROUND Growth differentiation factor 15(GDF-15)has been explored as a potential biomarker for various inflammatory diseases and cardiovascular events.This study aimed to assess the predictive role of GDF-15 levels in cardiovascular events and all-cause mortality,considering traditional risk factors and other biomarkers.METHODS A prospective study was conducted and 3699 patients with stable coronary artery disease(CAD)were enrolled into the research.Baseline GDF-15 levels were measured.Median follow-up was 3.1 years during the study.We analyzed clinical variables and several biomarkers.Multivariable Cox regression analysis was performed to evaluate prognostic performance of GDF-15 levels in predicting myocardial infarction(MI),heart failure,stroke,cardiovascular death,and non-cardiovascular death.RESULTS Baseline GDF-15 levels for 3699 patients were grouped by quartile(≤1153,1153-1888,1888-3043,3043 ng/L).Higher GDF-15 levels were associated with older age,male gender,history of hypertension,and elevated levels of N-terminal pro Btype natriuretic peptide(NT-pro BNP),soluble suppression of tumorigenesis-2(sST2),and creatine(each with P0.001).Adjusting for established risk factors and biomarkers in Cox proportional hazards models,a 1 standard deviation(SD)increase in GDF-15 was associated with elevated risk of clinical events[hazard ratio(HR)=2.18,95%confidence interval(CI):(1.52-3.11)],including:MI[HR=2.8395%CI:(1.03-7.74)],heart failure[HR=2.7195%CI:(1.18-6.23)],cardiovascular and non-cardiovascular death[HR=2.48,95%CI(1.49-4.11)]during the median follow up of 3.1 years.CONCLUSIONS Higher levels of GDF-15 consistently provides prognostic information for cardiovascular events and all cause death,independent of clinical risk factors and other biomarkers.GDF-15 could be considered as a valuable addition to future risk prediction model in secondary prevention for predicting clinical events in patient with stable CAD.