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Growth Differentiat...
Growth Differentiation Factor 15 for Risk Stratification and Selection of an Invasive Treatment Strategy in Non-ST-Elevation Acute Coronary Syndrome
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Wollert, Kai C (författare)
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Kempf, Tibor (författare)
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- Lagerqvist, Bo, 1952- (författare)
- Uppsala universitet,Institutionen för medicinska vetenskaper,Uppsala kliniska forskningscentrum (UCR),UCR
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- Lindahl, Bertil, 1957- (författare)
- Uppsala universitet,Institutionen för medicinska vetenskaper,Uppsala kliniska forskningscentrum (UCR),UCR
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- Olofsson, Sylvia (författare)
- Uppsala universitet,Institutionen för medicinska vetenskaper,Uppsala kliniska forskningscentrum (UCR)
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Allhoff, Tim (författare)
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Peter, Timo (författare)
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- Siegbahn, Agneta (författare)
- Uppsala universitet,Institutionen för medicinska vetenskaper
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- Venge, Per (författare)
- Uppsala universitet,Institutionen för medicinska vetenskaper
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Drexler, Helmut (författare)
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- Wallentin, Lars, 1943- (författare)
- Uppsala universitet,Institutionen för medicinska vetenskaper,Uppsala kliniska forskningscentrum (UCR),UCR
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(creator_code:org_t)
- 2007
- 2007
- Engelska.
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Ingår i: Circulation. - 0009-7322 .- 1524-4539. ; 116:14, s. 1540-1548
- Relaterad länk:
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http://www.ncbi.nlm....
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Background— An invasive treatment strategy improves outcomein patients with non–ST-elevation acute coronary syndromeat moderate to high risk. We hypothesized that the circulatinglevel of growth differentiation factor 15 (GDF-15) may improverisk stratification. Methods and Results— The Fast Revascularization duringInStability in Coronary artery disease II (FRISC-II) trial randomizedpatients with non–ST-elevation acute coronary syndrometo an invasive or conservative strategy with a follow-up for2 years. GDF-15 and other biomarkers were determined on admissionin 2079 patients. GDF-15 was moderately elevated (between 1200and 1800 ng/L) in 770 patients (37.0%), and highly elevated(>1800 ng/L) in 493 patients (23.7%). Elevated levels ofGDF-15 independently predicted the risk of the composite endpoint of death or recurrent myocardial infarction in the conservativegroup (P=0.016) but not in the invasive group. A significantinteraction existed between the GDF-15 level on admission andthe effect of treatment strategy on the composite end point.The occurrence of the composite end point was reduced by theinvasive strategy at GDF-15 levels >1800 ng/L (hazard ratio,0.49; 95% confidence interval, 0.33 to 0.73; P=0.001), between1200 and 1800 ng/L (hazard ratio, 0.68; 95% confidence interval,0.46 to 1.00; P=0.048), but not <1200 ng/L (hazard ratio,1.06; 95% confidence interval, 0.68 to 1.65; P=0.81). Patientswith ST-segment depression or a troponin T level >0.01 µg/Lwith a GDF-15 level <1200 ng/L did not benefit from the invasivestrategy. Conclusions— GDF-15 is a potential tool for risk stratificationand therapeutic decision making in patients with non–ST-elevationacute coronary syndrome as initially diagnosed by ECG and troponinlevels. A prospective randomized trial is needed to validatethese findings.
Nyckelord
- Acute Disease
- Aged
- Biological Markers/*blood
- Coronary Artery Disease/*blood/diagnosis/epidemiology/*therapy
- Cytokines/*blood
- Electrocardiography
- Female
- Humans
- Male
- Middle Aged
- Myocardial Revascularization
- Risk Factors
- Treatment Outcome
- Troponin T/blood
- MEDICINE
- MEDICIN
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Wollert, Kai C
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Kempf, Tibor
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Lagerqvist, Bo, ...
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Lindahl, Bertil, ...
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Olofsson, Sylvia
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Allhoff, Tim
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Peter, Timo
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Siegbahn, Agneta
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Venge, Per
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Drexler, Helmut
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Wallentin, Lars, ...
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visa färre...
- Artiklar i publikationen
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Circulation
- Av lärosätet
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Uppsala universitet