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Prognostic value of...
Prognostic value of growth-differentiation factor-15 in patients with 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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Peter, Timo (författare)
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- Olofsson, Sylvia, 1955- (författare)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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- James, Stefan, 1964- (författare)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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- Johnston, Nina (författare)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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- Lindahl, Bertil, 1957- (författare)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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Horn-Wichmann, Rüdiger (författare)
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Brabant, Georg (författare)
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Simoons, Maarten L. (författare)
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Armstrong, Paul W. (författare)
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Califf, Robert M. (författare)
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Drexler, Helmut (författare)
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- Wallentin, Lars, 1943- (författare)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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(creator_code:org_t)
- 2007
- 2007
- Engelska.
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Ingår i: Circulation. - 0009-7322 .- 1524-4539. ; 115:8, s. 962-971
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- BACKGROUND: Growth-differentiation factor-15 (GDF-15) is a member of the transforming growth factor-beta cytokine superfamily that is induced in the heart after ischemia-and-reperfusion injury. Circulating levels of GDF-15 may provide prognostic information in patients with non-ST-elevation acute coronary syndrome. METHODS AND RESULTS: Blood samples were obtained on admission from 2081 patients with acute chest pain and either ST-segment depression or troponin elevation who were included in the Global Utilization of Strategies to Open Occluded Arteries (GUSTO)-IV Non-ST-Elevation Acute Coronary Syndrome trial and from a matching cohort of 429 apparently healthy individuals. GDF-15 levels were determined by immunoradiometric assay. Approximately two thirds of patients presented with GDF-15 levels above the upper limit of normal in healthy controls (1200 ng/L); one third presented with levels >1800 ng/L. Increasing tertiles of GDF-15 were associated with an enhanced risk of death at 1 year (1.5%, 5.0%, and 14.1%; P<0.001). By multiple Cox regression analysis, only the levels of GDF-15 and N-terminal pro-B-type natriuretic peptide, together with age and a history of previous myocardial infarction, contributed independently to 1-year mortality risk. Receiver operating characteristic curve analyses further illustrated that GDF-15 is a strong marker of 1-year mortality risk (area under the curve, 0.757; best cutoff, 1808 ng/L). At this cutoff value, GDF-15 added significant prognostic information in patient subgroups defined by age; gender; time from symptom onset to admission; cardiovascular risk factors; previous cardiovascular disease; and the risk markers ST-segment depression, troponin T, N-terminal pro-B-type natriuretic peptide, C-reactive protein, and creatinine clearance. CONCLUSIONS: GDF-15 is a new biomarker of the risk for death in patients with non-ST-elevation acute coronary syndrome that provides prognostic information beyond that provided by established clinical and biochemical markers.
Nyckelord
- Acute coronary syndrome
- Biomarkers
- Growth-differentiation factor-15
- Prognosis
- 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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Peter, Timo
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Olofsson, Sylvia ...
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James, Stefan, 1 ...
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Johnston, Nina
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visa fler...
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Lindahl, Bertil, ...
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Horn-Wichmann, R ...
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Brabant, Georg
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Simoons, Maarten ...
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Armstrong, Paul ...
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Califf, Robert M ...
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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